Massage Therapy Appointment
Thai Acupressure is a therapy that can be very effective in treating orthopedic disorders that are commonly associated with babyfeeding, such as stiff neck and shoulders, arm and wrist pain, headaches, back pain. Using a combination of techniques we will aim to alleviate pain, increase mobility and range of motion, restore balance to the body, and prevent injury. Astra will be offering 30, 45, and 60 minute massage sessions. These sessions will take place in our consultation rooms. You will remain clothed and are welcome to bring your baby.
Email address *
Client First and Last Name *
Your answer
Client Preferred Contact Phone Number *
Your answer
How old is your baby? *
Your answer
Have you had any recent injuries or surgeries?
Your answer
In what area are you experiencing pain/stiffness/limit in mobility?
Your answer
If under the care of a physician, are there any conditions I should be aware of?
Your answer
Are you taking any prescription medications? If so, please list.
Your answer
Any other relevant conditions experienced currently or in the past? (cardiovascular, musculoskeletal, neurological, endocrine, respiratory, digestive, urinary, mental health, skin, cancer)
Your answer
Thanks for providing your information! We will be in touch via text shortly to schedule your massage session!
Submit
Never submit passwords through Google Forms.
This form was created inside of Breastfeeding Outreach For Greater Washington.