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Healing Handsof Westford

Oncology Massage Intake Form

For clients in active treatment, in recovery, or living with a history of cancer. Lynn adapts pressure, positioning and session length around your treatment.

Fields marked * are required. Your answers and signed policy are emailed to the practice, and a copy is sent to you.

Your details
Health history

This helps Lynn adapt pressure, positioning and technique. Share only what you're comfortable sharing — you can also discuss anything in person.

Do any of the following apply to you?

Check all that apply.

Are you currently under the care of a physician or other provider?
Treatment details
Treatments received (past or current)
Ports, devices or surgical sites
Current side effects
Has your oncology team cleared you for massage?
Session preferences
Preferred pressure
Areas you'd prefer Lynn avoid
Consent
Cancellation policy & signature

Please read the policy below and sign once — this covers both your intake form and the cancellation, late arrival and no-show policy.

CANCELLATION, LATE ARRIVAL, & NO-SHOW POLICY

Thank you for trusting us as your massage therapy provider. We respect your time and ask for the same courtesy in return. These policies help us provide consistent, high-quality care while keeping appointment times available for every client.

Cancellations

Please provide at least 24 hours’ notice if you need to cancel or reschedule an appointment. Cancellations made with less than 24 hours’ notice will incur a fee equal to 50% of the scheduled service. For prepaid packages, one session will be deducted.

To cancel or reschedule, contact us by phone or through our online booking system. We do not accept cancellations through social media.

Late Arrivals

Please arrive 5–10 minutes before your appointment. A 5-minute grace period is provided. After that, your session may be shortened so the next client’s appointment can begin on time. Arrivals more than 15 minutes late may need to be rescheduled and may be subject to a fee. Full payment is required when a session is shortened because of a late arrival.

For your first appointment, please arrive 15 minutes early to complete any remaining intake paperwork. This helps your session begin on time.

No-Shows

A no-show means missing an appointment without providing prior notice. The full scheduled-service fee will be charged. Clients using a prepaid package will forfeit one session, and appointments booked with a gift certificate will lose the session’s value.

Two or more no-shows within six months may result in required prepayment or suspended booking privileges. A third no-show or late cancellation may result in being unable to reschedule for up to six months.

Emergencies & Exceptions

We understand that unexpected situations happen. Exceptions may be made for illness, verifiable emergencies, or inclement weather at management’s discretion.

By booking an appointment, you acknowledge and agree to this policy.

Sign above using your finger, stylus, or mouse.

Your information is emailed directly to the practice and treated confidentially.

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