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Kundala Massage Level 1 Client Intake Form

1. Client First and Last Name

2. Date

3. Pressure Preference: does it differ from area to area?

Light

Medium

Deep

4. On a scale from 1-5 what would you prefer?

1: A targeted, focused, structural massage.
5: A flowy, hypnotic, energetic massage.

5. Places to Avoid

None

Hair

Face

Feet

Other

If other, please list

6. Please specify skin conditions, past or current injuries that may interfere with the massage. If none, put NA

7. For our own marketing information how did you find out about us?

8. Glute Work: Is recommended and is standard in our services, but we wish to accomodate your comfort. Please specify what you would prefer

Glute Preference

Disclaimer
By checking each box and signing below, you agree to and understand the following:

What Level 1 Kundala Massage Is: A hypnotic, flowy style of massage that uses touch synced with rhythmic music to deliver a theraputic-tactile performance. The Artist perfoms a Kundala version of a Swedish massage and remains on the ground, only getting on the extension table to access the neck, head, and shoulders. The Artist does not get on the table when the client is face down, and does not use their legs as additional massage tools during the session at any time.

Music: Music during a Kundala Massage is more upbeat than traditional spa music. Its rhythmic tones act as a meduim for the Artist to flow, and is a highlight of each service. We use a large library of songs, some of which may contain adult language or themes. Regardless of content, all music is solely meant to aid in the artistry of the massage and should not be misinterpreted as anything else.

Draping: Our drape is a handmade piece you step into, that securely covers private areas while leaving everything else accessible. This minimal draping allows the Artist to move smoothly between muscle groups. Your Artist will demonstrate how to put it on. Multiple layers of towels are also used on the front for additional privacy. Individuals who identify as female will be covered with a towel on their chest, in addition to their provided coverings.

Proper Client Etiquette: Kundala Massage is an artform and should be treated and respected as such. As a client, you agree not to actively touch the Artist or engage in provocative behavior. Doing so is not only distracting to the Artist, but is against company policy, and will result in warnings/ termination of the appointment, and suspension of future appointments.

Medical: Kundala Massage is not meant to replace medical advice or treatment. For advice or treatment outside the scope of massage, please refer to your physician.

Covid Disclaimer: Masks are optional for Artist and Client; all Artists are vaccinated and masks can be worn upon request.

Temperature and Oil: Our massage rooms are typically kept at 80-83 degrees Fahrenheit. When you are on the table at the beginning of your session, please let the Artist know if you are uncomfortable in any way. Additionally, during our massage services, the Artists use a large amount of unscented hypo-allergenic massage oil. Oil is notoriously difficult to get out of material. You may feel some oil residue on the sheet, but please understand that the sheets are diligently cleaned.

Communication: As a client, you agree to inform the Artist if you are in pain or uncomfortable at any point during the massage, so the Artist can make proper adjustments.

Client Signature

Staff Only Below This Line

LMT Name

LMT Signature

Thanks for submitting!

4885 south 900 east Millcreek, UT 84117
suit 235

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