before your visit please fill out the

Questionnaire

Before Your Visit

We at Halcyon Bodyworks look forward to working with you. Please note this form is to be filled out a minimum of 8 hours before your appointment. Due to the new circumstances circulating the globe, we have made some changes around the office. We appreciate your grace and adaptability during this shift.

We are here to walk you through these changes and appreciate communication and feedback while we all adjust.

CLIENT INFORMATION:

MASSAGE INFORMATION:

After finishing this form please go to our insurance form.

COVID-19 RELATED QUESTIONS:

NEW CLIENT FLOW:

1. If you arrive early, please wait in your vehicle until 5-6 minutes before your massage starting time.
2. Only 2 clients allowed in the waiting area at a time, including the chiropractor. Please do not sit on the cloth chairs.
3. Bring only essentials: cell phone, face mask or covering (if you forget one your therapist will provide you with a bandana) and wallet.
4. Wash hands for 20 seconds immediately when entering Halcyon Bodyworks (we'll walk you to the sink).

Air purifiers have been added to the office. We clean/sanitize between each client with a 30 minute gap between appointments. If you did not bring a mask your massage therapist will place a bandana over your mouth/nose when you are face up.

I understand that, because massage therapy work involves maintained touch and close physical proximity over an extended period of time, there may be an elevated risk of disease transmission, including COVID-19. By signing this form, I acknowledge that I am aware of the risks involved and give consent to receive massage and bodywork from this practitioner.

halcyon bodyworks

Visit Us

224 SE Miller Ave., Bend, OR 97702
541-306-0988

hours

Monday – Friday:
9 am - 7 pm
​Weekends 9 am - 6 pm

By appointment only, same day appointments may be available, call to ask about last minute cancellations.

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