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Intake Forms for Your First Visit

Nancy Hausauer, LMP
706 Sixth Avenue * Tacoma, WA 98405 * 253-686-1214

Massage, lymphatic massage, and energy healing serving Tacoma, Seattle,
Federal Way, Puyallup, Lakewood, Olympia, and the Puget Sound region



Prior to your first session with me, I need you to fill out three forms.

The first is a medical information form. Filling it out accurately ensures that I can provide you with a medically safe massage, and help you meet your health and wellness goals.

The second is a HIPPA form. HIPPA form. It informs you of your privacy rights, and ensures that I will keep all your intake form and all information related to our sessions together private.

The third is an explanation of my policies, which I request that you download, read, and sign.

If you download them and fill them out prior to our first session, you will be able to have more time "on the table."

That will make us both happy!

Please feel free to call me if you have any questions.

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Client comments:

"My back feels so much better it's miraculous. I laughed today for the first time in weeks."

"My body feels so much better. You gave a new lease on life!"

"Things just go better when I see you regularly."



I can help you:
  • relieve pain
  • overcome chronic stress & anxiety
  • increase vitality
  • relax deeply
  • heal from surgery and injury
  • support your immune system
  • achieve greater clarity, insight, & personal growth
  • navigate life transitions & challenges
  • nurture creativity
  • stay well, feel great, and live your life to the fullest.




More client comments:

"Profoundly relaxing."

"Wow! I feel phenomenal! Thank you so much for the treatment today! You were so accurate finding my low back pain's specific spot, and I wanted to let you know that I haven't felt this good in a long time."

"After our last session, I just kept getting better and better and better. I feel more like myself than I have in ten years."