Intake Form | The Sacred Technician

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Sacred Sessions Intake Form

First name

Last name

Birthday

Jour

Mois

Année

Phone

If you are scheduling the Blissful Balance, Deep Tissue Bamboo, or Hot Stone Ohm; What is your draping preference?

Fully draped

Partially draped

Nude

N/A

Do you have any known allergies? Are you allergic to any specific oils or fragrances?

Please indicate if you have any history of broken bones, fractures, or dislocations. If so, please provide details, including the location and approximate date of the injury.

Are there any particular areas where you would like us to dedicate more attention?

What would you like to receive from this session?

If you are female please indicate if you will be on your moon the day of the appointment:

Yes

Not sure

Not applicable

Please indicate your payment method for your session:

Cash

Cashapp: $SacredTea

Credit card or debit card (online)

PayPal Email: Info@TheSacredTechnician.com

Venmo; @SacredTea

Zelle Email: Info@TheSacredTechnician.com

Credit card or debit card (in person)

Other

How did you hear about The Sacred Technician?

Date and time

Jour

Mois

Année

Heure

:HeuresMinutes

Please list an emergency contact:

+1 404 783 9803

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Opening Hours:

Mon------------------ 6:00 AM-3:30 PM
Tue------------------- 6:00 AM-3:30 PM
Wed------------------ 6:00 AM-3:30 PM
Thur------------------ 6:00 AM-3:30 PM
Fri--------------------- 6:00 AM-3:30 PM

Sun------------------- 9:00 AM-12:00 PM