Cindy Latham, CMT

Contact Me:
massage@cindylathamcmt.com
303-919-8656

hello and welcome! I'm looking forward to your visit. Please take a few minutes before your appointment to complete your intake form. You will receive a confirmation email after you click "Submit". Please click the link you receive in that email to complete your submission. You may also receive appointment reminders or special offers from time to time. Please complete as much information as you can. * These fields are required.
Date: * Email Address: * First Name: * Last Name: * Address: City: State: Zip Code:	Primary Phone: Secondary Phone: Birth Date: Occupation: Referred By: Significant Other's Name and Phone #: Emergency Contact Name and Phone Number (If Different from Above):
Have you received massage before, and if so how long ago/how often? What is your reason for seeking massage at this time? Exercise or Sports You Participate In: Physical Intake Please list any current health concerns including infectious diseases, recent injuries or surgeries, and any conditions for which you are currently taking medications: Please list any known allergies: * Cancellation Policy Please be aware that I have a 24-hour cancellation policy in effect to allow both of us time to make other arrangements. If you cannot make your scheduled appointment, please contact me as soon as possible. * Informed Consent Massage therapy is intended to enhance relaxation, reduce pain caused by muscle tension, increase range of motion, assist in healing injuries, improve circulation and offer a positive experience of touch. It can also be a very effective tool in self-discovery and releasing old, and outlived behaviors. Massage therapy is not a substitute for medical treatment or medications and it is not the role of a massage therapist to diagnose illness or disease, prescribe medications or perform spinal manipulations. * Enter the letters shown above: Please Note: Your information will be used solely by Cindy Latham, CMT and will not be disclosed to third parties.