recoverytimemassage.com
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Submitted URL: https://www.recoverytimemassage.com/
Effective URL: https://recoverytimemassage.com/
Submission: On November 23 via api from US — Scanned from DE
Effective URL: https://recoverytimemassage.com/
Submission: On November 23 via api from US — Scanned from DE
Form analysis 3 forms found in the DOM
GET https://recoverytimemassage.com/
<form role="search" method="get" class="et-search-form" action="https://recoverytimemassage.com/">
<input type="search" class="et-search-field" placeholder="Search …" value="" name="s" title="Search for:">
</form>POST /#gf_3
<form method="post" enctype="multipart/form-data" target="gform_ajax_frame_3" id="gform_3" action="/#gf_3" data-formid="3">
<input type="hidden" class="gforms-pum" value="{"closepopup":false,"closedelay":0,"openpopup":false,"openpopup_id":0}">
<div class="gform-body gform_body">
<div id="gform_fields_3" class="gform_fields top_label form_sublabel_below description_below">
<div id="field_3_1" class="gfield gfield--type-email gfield_contains_required field_sublabel_below gfield--no-description field_description_below hidden_label gfield_visibility_visible" data-js-reload="field_3_1"><label
class="gfield_label gform-field-label" for="input_3_1">Email<span class="gfield_required"><span class="gfield_required gfield_required_text">(Required)</span></span></label>
<div class="ginput_container ginput_container_email">
<input name="input_1" id="input_3_1" type="text" value="" class="large" placeholder="Enter your email address..." aria-required="true" aria-invalid="false">
</div>
</div>
<div id="field_3_2" class="gfield gfield--type-captcha gfield--width-full field_sublabel_below gfield--no-description field_description_below hidden_label gfield_visibility_visible" data-js-reload="field_3_2"><label
class="gfield_label gform-field-label" for="input_3_2">CAPTCHA</label>
<div id="input_3_2" class="ginput_container ginput_recaptcha gform-initialized" data-sitekey="6Le44u0iAAAAAOCRB3lxSEhkxdDNpjJQv-RnyTDe" data-theme="light" data-tabindex="0" data-badge="">
<div style="width: 304px; height: 78px;">
<div><iframe title="reCAPTCHA" width="304" height="78" role="presentation" name="a-9zernmg4n6lp" frameborder="0" scrolling="no"
sandbox="allow-forms allow-popups allow-same-origin allow-scripts allow-top-navigation allow-modals allow-popups-to-escape-sandbox allow-storage-access-by-user-activation"
src="https://www.google.com/recaptcha/api2/anchor?ar=1&k=6Le44u0iAAAAAOCRB3lxSEhkxdDNpjJQv-RnyTDe&co=aHR0cHM6Ly9yZWNvdmVyeXRpbWVtYXNzYWdlLmNvbTo0NDM.&hl=en&v=-QbJqHfGOUB8nuVRLvzFLVed&theme=light&size=normal&cb=bhip9mlpyxwu"></iframe>
</div><textarea id="g-recaptcha-response" name="g-recaptcha-response" class="g-recaptcha-response"
style="width: 250px; height: 40px; border: 1px solid rgb(193, 193, 193); margin: 10px 25px; padding: 0px; resize: none; display: none;"></textarea>
</div>
</div>
</div>
</div>
</div>
<div class="gform_footer top_label"> <input type="submit" id="gform_submit_button_3" class="gform_button button" value="Submit" onclick="if(window["gf_submitting_3"]){return false;} window["gf_submitting_3"]=true; "
onkeypress="if( event.keyCode == 13 ){ if(window["gf_submitting_3"]){return false;} window["gf_submitting_3"]=true; jQuery("#gform_3").trigger("submit",[true]); }"> <input type="hidden" name="gform_ajax"
value="form_id=3&title=&description=&tabindex=0&theme=data-form-theme='gravity-theme'">
<input type="hidden" class="gform_hidden" name="is_submit_3" value="1">
<input type="hidden" class="gform_hidden" name="gform_submit" value="3">
<input type="hidden" class="gform_hidden" name="gform_unique_id" value="">
<input type="hidden" class="gform_hidden" name="state_3" value="WyJbXSIsIjhiNmYxZGQ3YTczZDZhZjkxZTEyOTZmOWE4YzU2Y2M3Il0=">
<input type="hidden" class="gform_hidden" name="gform_target_page_number_3" id="gform_target_page_number_3" value="0">
<input type="hidden" class="gform_hidden" name="gform_source_page_number_3" id="gform_source_page_number_3" value="1">
<input type="hidden" name="gform_field_values" value="">
</div>
<input type="hidden" name="pum_form_popup_id" value="896">
</form>POST /#gf_4
<form method="post" enctype="multipart/form-data" target="gform_ajax_frame_4" id="gform_4" action="/#gf_4" data-formid="4">
<div id="gf_page_steps_4" class="gf_page_steps">
<div id="gf_step_4_1" class="gf_step gf_step_active gf_step_first"><span class="gf_step_number">1</span><span class="gf_step_label">Client Intake Form</span></div>
<div id="gf_step_4_2" class="gf_step gf_step_next gf_step_pending"><span class="gf_step_number">2</span><span class="gf_step_label">General Liability Release Form</span></div>
<div id="gf_step_4_3" class="gf_step gf_step_last gf_step_pending"><span class="gf_step_number">3</span><span class="gf_step_label">Policies</span></div>
</div>
<input type="hidden" class="gforms-pum" value="{"closepopup":false,"closedelay":0,"openpopup":false,"openpopup_id":0}">
<div class="gform-body gform_body">
<div id="gform_page_4_1" class="gform_page " data-js="page-field-id-1">
<div class="gform_page_fields">
<div id="gform_fields_4" class="gform_fields top_label form_sublabel_below description_below">
<div id="field_4_1" class="gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_4_1">
<h3 class="gsection_title">Personal Information</h3>
</div>
<fieldset id="field_4_3" class="gfield gfield--type-name gfield--width-full gfield_contains_required field_sublabel_hidden_label gfield--no-description field_description_below hidden_label gfield_visibility_visible"
data-js-reload="field_4_3">
<legend class="gfield_label gform-field-label gfield_label_before_complex">Name<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></legend>
<div class="ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row" id="input_4_3">
<span id="input_4_3_3_container" class="name_first gform-grid-col gform-grid-col--size-auto">
<input type="text" name="input_3.3" id="input_4_3_3" value="" aria-required="true" placeholder="First name">
<label for="input_4_3_3" class="gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text">First</label>
</span>
<span id="input_4_3_6_container" class="name_last gform-grid-col gform-grid-col--size-auto">
<input type="text" name="input_3.6" id="input_4_3_6" value="" aria-required="true" placeholder="Last name">
<label for="input_4_3_6" class="gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text">Last</label>
</span>
</div>
</fieldset>
<div id="field_4_4" class="gfield gfield--type-phone gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below hidden_label gfield_visibility_visible" data-js-reload="field_4_4"><label
class="gfield_label gform-field-label" for="input_4_4">Phone<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_phone"><input name="input_4" id="input_4_4" type="text" value="" class="large" placeholder="Phone #" aria-required="true" aria-invalid="false"></div>
</div>
<div id="field_4_5"
class="gfield gfield--type-date gfield--input-type-datepicker gfield--datepicker-default-icon gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below hidden_label gfield_visibility_visible"
data-js-reload="field_4_5"><label class="gfield_label gform-field-label" for="input_4_5">Date of Birth<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_date">
<input name="input_5" id="input_4_5" type="text" value="" class="datepicker gform-datepicker mdy datepicker_with_icon gdatepicker_with_icon hasDatepicker initialized" placeholder="Date of Birth" aria-describedby="input_4_5_date_format"
aria-invalid="false" aria-required="true"><img class="ui-datepicker-trigger" src="https://recoverytimemassage.com/wp-content/plugins/gravityforms/images/datepicker/datepicker.svg" alt="Select date" title="Select date">
<span id="input_4_5_date_format" class="screen-reader-text">MM slash DD slash YYYY</span>
</div>
<input type="hidden" id="gforms_calendar_icon_input_4_5" class="gform_hidden" value="https://recoverytimemassage.com/wp-content/plugins/gravityforms/images/datepicker/datepicker.svg">
</div>
<div id="field_4_42" class="gfield gfield--type-email gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below hidden_label gfield_visibility_visible" data-js-reload="field_4_42"><label
class="gfield_label gform-field-label" for="input_4_42">Email<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_email">
<input name="input_42" id="input_4_42" type="text" value="" class="large" placeholder="Email address" aria-required="true" aria-invalid="false">
</div>
</div>
<div id="field_4_43" class="gfield gfield--type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below hidden_label gfield_visibility_visible" data-js-reload="field_4_43"><label
class="gfield_label gform-field-label" for="input_4_43">Untitled<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_text"><input name="input_43" id="input_4_43" type="text" value="" class="large" placeholder="Occupation" aria-required="true" aria-invalid="false"> </div>
</div>
<fieldset id="field_4_6" class="gfield gfield--type-address gfield--width-full gfield_contains_required field_sublabel_hidden_label gfield--no-description field_description_below hidden_label gfield_visibility_visible"
data-js-reload="field_4_6">
<legend class="gfield_label gform-field-label gfield_label_before_complex">Address<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></legend>
<div class="ginput_complex ginput_container has_street has_city has_state has_zip ginput_container_address gform-grid-row" id="input_4_6">
<span class="ginput_full address_line_1 ginput_address_line_1 gform-grid-col" id="input_4_6_1_container">
<input type="text" name="input_6.1" id="input_4_6_1" value="" placeholder="Street Address" aria-required="true">
<label for="input_4_6_1" id="input_4_6_1_label" class="gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text">Street Address</label>
</span><span class="ginput_left address_city ginput_address_city gform-grid-col" id="input_4_6_3_container">
<input type="text" name="input_6.3" id="input_4_6_3" value="" placeholder="City" aria-required="true">
<label for="input_4_6_3" id="input_4_6_3_label" class="gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text">City</label>
</span><span class="ginput_right address_state ginput_address_state gform-grid-col" id="input_4_6_4_container">
<select name="input_6.4" id="input_4_6_4" aria-required="true">
<option value="" selected="selected">State</option>
<option value="Alabama">Alabama</option>
<option value="Alaska">Alaska</option>
<option value="American Samoa">American Samoa</option>
<option value="Arizona">Arizona</option>
<option value="Arkansas">Arkansas</option>
<option value="California">California</option>
<option value="Colorado">Colorado</option>
<option value="Connecticut">Connecticut</option>
<option value="Delaware">Delaware</option>
<option value="District of Columbia">District of Columbia</option>
<option value="Florida">Florida</option>
<option value="Georgia">Georgia</option>
<option value="Guam">Guam</option>
<option value="Hawaii">Hawaii</option>
<option value="Idaho">Idaho</option>
<option value="Illinois">Illinois</option>
<option value="Indiana">Indiana</option>
<option value="Iowa">Iowa</option>
<option value="Kansas">Kansas</option>
<option value="Kentucky">Kentucky</option>
<option value="Louisiana">Louisiana</option>
<option value="Maine">Maine</option>
<option value="Maryland">Maryland</option>
<option value="Massachusetts">Massachusetts</option>
<option value="Michigan">Michigan</option>
<option value="Minnesota">Minnesota</option>
<option value="Mississippi">Mississippi</option>
<option value="Missouri">Missouri</option>
<option value="Montana">Montana</option>
<option value="Nebraska">Nebraska</option>
<option value="Nevada">Nevada</option>
<option value="New Hampshire">New Hampshire</option>
<option value="New Jersey">New Jersey</option>
<option value="New Mexico">New Mexico</option>
<option value="New York">New York</option>
<option value="North Carolina">North Carolina</option>
<option value="North Dakota">North Dakota</option>
<option value="Northern Mariana Islands">Northern Mariana Islands</option>
<option value="Ohio">Ohio</option>
<option value="Oklahoma">Oklahoma</option>
<option value="Oregon">Oregon</option>
<option value="Pennsylvania">Pennsylvania</option>
<option value="Puerto Rico">Puerto Rico</option>
<option value="Rhode Island">Rhode Island</option>
<option value="South Carolina">South Carolina</option>
<option value="South Dakota">South Dakota</option>
<option value="Tennessee">Tennessee</option>
<option value="Texas">Texas</option>
<option value="Utah">Utah</option>
<option value="U.S. Virgin Islands">U.S. Virgin Islands</option>
<option value="Vermont">Vermont</option>
<option value="Virginia">Virginia</option>
<option value="Washington">Washington</option>
<option value="West Virginia">West Virginia</option>
<option value="Wisconsin">Wisconsin</option>
<option value="Wyoming">Wyoming</option>
<option value="Armed Forces Americas">Armed Forces Americas</option>
<option value="Armed Forces Europe">Armed Forces Europe</option>
<option value="Armed Forces Pacific">Armed Forces Pacific</option>
</select>
<label for="input_4_6_4" id="input_4_6_4_label" class="gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text">State</label>
</span><span class="ginput_left address_zip ginput_address_zip gform-grid-col" id="input_4_6_5_container">
<input type="text" name="input_6.5" id="input_4_6_5" value="" placeholder="ZIP" aria-required="true">
<label for="input_4_6_5" id="input_4_6_5_label" class="gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text">ZIP Code</label>
</span><input type="hidden" class="gform_hidden" name="input_6.6" id="input_4_6_6" value="United States">
<div class="gf_clear gf_clear_complex"></div>
</div>
</fieldset>
<fieldset id="field_4_7" class="gfield gfield--type-name gfield--width-half field_sublabel_hidden_label gfield--no-description field_description_below hidden_label gfield_visibility_visible" data-js-reload="field_4_7">
<legend class="gfield_label gform-field-label gfield_label_before_complex">Emergency Contact Name</legend>
<div class="ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name no_last_name no_suffix gf_name_has_1 ginput_container_name gform-grid-row" id="input_4_7">
<span id="input_4_7_3_container" class="name_first gform-grid-col gform-grid-col--size-auto">
<input type="text" name="input_7.3" id="input_4_7_3" value="" aria-required="false" placeholder="Emergency Contact Name">
<label for="input_4_7_3" class="gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text">First</label>
</span>
</div>
</fieldset>
<div id="field_4_9" class="gfield gfield--type-phone gfield--width-half field_sublabel_below gfield--no-description field_description_below hidden_label gfield_visibility_visible" data-js-reload="field_4_9"><label
class="gfield_label gform-field-label" for="input_4_9">Emergency Contact Phone #</label>
<div class="ginput_container ginput_container_phone"><input name="input_9" id="input_4_9" type="text" value="" class="large" placeholder="Emergency Contact #" aria-invalid="false"></div>
</div>
<div id="field_4_10" class="gfield gfield--type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below hidden_label gfield_visibility_visible" data-js-reload="field_4_10"><label
class="gfield_label gform-field-label" for="input_4_10">How Did You Hear About Us?</label>
<div class="ginput_container ginput_container_text"><input name="input_10" id="input_4_10" type="text" value="" class="large" placeholder="How did you hear about us?" aria-invalid="false"> </div>
</div>
<div id="field_4_11" class="gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_4_11">
<h3 class="gsection_title">Medical Information</h3>
</div>
<fieldset id="field_4_14" class="gfield gfield--type-radio gfield--type-choice gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible"
data-js-reload="field_4_14">
<legend class="gfield_label gform-field-label">Are you taking any medications?<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></legend>
<div class="ginput_container ginput_container_radio">
<div class="gfield_radio" id="input_4_14">
<div class="gchoice gchoice_4_14_0">
<input class="gfield-choice-input" name="input_14" type="radio" value="Yes" id="choice_4_14_0" onchange="gformToggleRadioOther( this )">
<label for="choice_4_14_0" id="label_4_14_0" class="gform-field-label gform-field-label--type-inline">Yes</label>
</div>
<div class="gchoice gchoice_4_14_1">
<input class="gfield-choice-input" name="input_14" type="radio" value="No" id="choice_4_14_1" onchange="gformToggleRadioOther( this )">
<label for="choice_4_14_1" id="label_4_14_1" class="gform-field-label gform-field-label--type-inline">No</label>
</div>
</div>
</div>
</fieldset>
<div id="field_4_13" class="gfield gfield--type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below hidden_label gfield_visibility_visible" data-js-reload="field_4_13"
data-conditional-logic="hidden" style="display: none;"><label class="gfield_label gform-field-label" for="input_4_13">Please List Name and Usage<span class="gfield_required"><span
class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_text"><input name="input_13" id="input_4_13" type="text" value="" class="large" placeholder="Please list name and usage:" aria-required="true" aria-invalid="false" disabled="disabled"> </div>
</div>
<fieldset id="field_4_12" class="gfield gfield--type-radio gfield--type-choice gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible"
data-js-reload="field_4_12">
<legend class="gfield_label gform-field-label">Are you currently pregnant?<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></legend>
<div class="ginput_container ginput_container_radio">
<div class="gfield_radio" id="input_4_12">
<div class="gchoice gchoice_4_12_0">
<input class="gfield-choice-input" name="input_12" type="radio" value="Yes" id="choice_4_12_0" onchange="gformToggleRadioOther( this )">
<label for="choice_4_12_0" id="label_4_12_0" class="gform-field-label gform-field-label--type-inline">Yes</label>
</div>
<div class="gchoice gchoice_4_12_1">
<input class="gfield-choice-input" name="input_12" type="radio" value="No" id="choice_4_12_1" onchange="gformToggleRadioOther( this )">
<label for="choice_4_12_1" id="label_4_12_1" class="gform-field-label gform-field-label--type-inline">No</label>
</div>
</div>
</div>
</fieldset>
<div id="field_4_15" class="gfield gfield--type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below hidden_label gfield_visibility_visible" data-js-reload="field_4_15"
data-conditional-logic="hidden" style="display: none;"><label class="gfield_label gform-field-label" for="input_4_15">How far along?<span class="gfield_required"><span
class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_text"><input name="input_15" id="input_4_15" type="text" value="" class="large" placeholder="How far along?" aria-required="true" aria-invalid="false" disabled="disabled"> </div>
</div>
<div id="field_4_16" class="gfield gfield--type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below hidden_label gfield_visibility_visible" data-js-reload="field_4_16"
data-conditional-logic="hidden" style="display: none;"><label class="gfield_label gform-field-label" for="input_4_16">Any high risk factors?<span class="gfield_required"><span
class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_text"><input name="input_16" id="input_4_16" type="text" value="" class="large" placeholder="Any high-risk factors?" aria-required="true" aria-invalid="false" disabled="disabled"> </div>
</div>
<fieldset id="field_4_21" class="gfield gfield--type-radio gfield--type-choice gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible"
data-js-reload="field_4_21">
<legend class="gfield_label gform-field-label">Do you suffer from chronic pain?<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></legend>
<div class="ginput_container ginput_container_radio">
<div class="gfield_radio" id="input_4_21">
<div class="gchoice gchoice_4_21_0">
<input class="gfield-choice-input" name="input_21" type="radio" value="Yes" id="choice_4_21_0" onchange="gformToggleRadioOther( this )">
<label for="choice_4_21_0" id="label_4_21_0" class="gform-field-label gform-field-label--type-inline">Yes</label>
</div>
<div class="gchoice gchoice_4_21_1">
<input class="gfield-choice-input" name="input_21" type="radio" value="No" id="choice_4_21_1" onchange="gformToggleRadioOther( this )">
<label for="choice_4_21_1" id="label_4_21_1" class="gform-field-label gform-field-label--type-inline">No</label>
</div>
</div>
</div>
</fieldset>
<div id="field_4_22" class="gfield gfield--type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below hidden_label gfield_visibility_visible" data-js-reload="field_4_22"
data-conditional-logic="hidden" style="display: none;"><label class="gfield_label gform-field-label" for="input_4_22">Please explain<span class="gfield_required"><span
class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_text"><input name="input_22" id="input_4_22" type="text" value="" class="large" placeholder="Please explain:" aria-required="true" aria-invalid="false" disabled="disabled"> </div>
</div>
<div id="field_4_24" class="gfield gfield--type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below hidden_label gfield_visibility_visible" data-js-reload="field_4_24"
data-conditional-logic="hidden" style="display: none;"><label class="gfield_label gform-field-label" for="input_4_24">What makes it better?<span class="gfield_required"><span
class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_text"><input name="input_24" id="input_4_24" type="text" value="" class="large" placeholder="What makes it better?" aria-required="true" aria-invalid="false" disabled="disabled"> </div>
</div>
<div id="field_4_23" class="gfield gfield--type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below hidden_label gfield_visibility_visible" data-js-reload="field_4_23"
data-conditional-logic="hidden" style="display: none;"><label class="gfield_label gform-field-label" for="input_4_23">What makes it worse?<span class="gfield_required"><span
class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_text"><input name="input_23" id="input_4_23" type="text" value="" class="large" placeholder="What makes it worse?" aria-required="true" aria-invalid="false" disabled="disabled"> </div>
</div>
<fieldset id="field_4_25" class="gfield gfield--type-radio gfield--type-choice gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible"
data-js-reload="field_4_25">
<legend class="gfield_label gform-field-label">Have you had any orthopedic injuries?<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></legend>
<div class="ginput_container ginput_container_radio">
<div class="gfield_radio" id="input_4_25">
<div class="gchoice gchoice_4_25_0">
<input class="gfield-choice-input" name="input_25" type="radio" value="Yes" id="choice_4_25_0" onchange="gformToggleRadioOther( this )">
<label for="choice_4_25_0" id="label_4_25_0" class="gform-field-label gform-field-label--type-inline">Yes</label>
</div>
<div class="gchoice gchoice_4_25_1">
<input class="gfield-choice-input" name="input_25" type="radio" value="No" id="choice_4_25_1" onchange="gformToggleRadioOther( this )">
<label for="choice_4_25_1" id="label_4_25_1" class="gform-field-label gform-field-label--type-inline">No</label>
</div>
</div>
</div>
</fieldset>
<div id="field_4_26" class="gfield gfield--type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below hidden_label gfield_visibility_visible" data-js-reload="field_4_26"
data-conditional-logic="hidden" style="display: none;"><label class="gfield_label gform-field-label" for="input_4_26">Please list:<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_text"><input name="input_26" id="input_4_26" type="text" value="" class="large" placeholder="Please list:" aria-required="true" aria-invalid="false" disabled="disabled"> </div>
</div>
<fieldset id="field_4_28" class="gfield gfield--type-checkbox gfield--type-choice gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible"
data-js-reload="field_4_28">
<legend class="gfield_label gform-field-label gfield_label_before_complex">Please indicate any of the following that apply to you:<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span>
</legend>
<div class="ginput_container ginput_container_checkbox">
<div class="gfield_checkbox" id="input_4_28">
<div class="gchoice gchoice_4_28_1">
<input class="gfield-choice-input" name="input_28.1" type="checkbox" value="Cancer" id="choice_4_28_1">
<label for="choice_4_28_1" id="label_4_28_1" class="gform-field-label gform-field-label--type-inline">Cancer</label>
</div>
<div class="gchoice gchoice_4_28_2">
<input class="gfield-choice-input" name="input_28.2" type="checkbox" value="Headaches/Migraines" id="choice_4_28_2">
<label for="choice_4_28_2" id="label_4_28_2" class="gform-field-label gform-field-label--type-inline">Headaches/Migraines</label>
</div>
<div class="gchoice gchoice_4_28_3">
<input class="gfield-choice-input" name="input_28.3" type="checkbox" value="Arthritis" id="choice_4_28_3">
<label for="choice_4_28_3" id="label_4_28_3" class="gform-field-label gform-field-label--type-inline">Arthritis</label>
</div>
<div class="gchoice gchoice_4_28_4">
<input class="gfield-choice-input" name="input_28.4" type="checkbox" value="Diabetes" id="choice_4_28_4">
<label for="choice_4_28_4" id="label_4_28_4" class="gform-field-label gform-field-label--type-inline">Diabetes</label>
</div>
<div class="gchoice gchoice_4_28_5">
<input class="gfield-choice-input" name="input_28.5" type="checkbox" value="Joint Replacement(s)" id="choice_4_28_5">
<label for="choice_4_28_5" id="label_4_28_5" class="gform-field-label gform-field-label--type-inline">Joint Replacement(s)</label>
</div>
<div class="gchoice gchoice_4_28_6">
<input class="gfield-choice-input" name="input_28.6" type="checkbox" value="High/Low Blood Pressure" id="choice_4_28_6">
<label for="choice_4_28_6" id="label_4_28_6" class="gform-field-label gform-field-label--type-inline">High/Low Blood Pressure</label>
</div>
<div class="gchoice gchoice_4_28_7">
<input class="gfield-choice-input" name="input_28.7" type="checkbox" value="Neuropathy" id="choice_4_28_7">
<label for="choice_4_28_7" id="label_4_28_7" class="gform-field-label gform-field-label--type-inline">Neuropathy</label>
</div>
<div class="gchoice gchoice_4_28_8">
<input class="gfield-choice-input" name="input_28.8" type="checkbox" value="Fibromyalgia" id="choice_4_28_8">
<label for="choice_4_28_8" id="label_4_28_8" class="gform-field-label gform-field-label--type-inline">Fibromyalgia</label>
</div>
<div class="gchoice gchoice_4_28_9">
<input class="gfield-choice-input" name="input_28.9" type="checkbox" value="Stroke" id="choice_4_28_9">
<label for="choice_4_28_9" id="label_4_28_9" class="gform-field-label gform-field-label--type-inline">Stroke</label>
</div>
<div class="gchoice gchoice_4_28_11">
<input class="gfield-choice-input" name="input_28.11" type="checkbox" value="Heart Attack" id="choice_4_28_11">
<label for="choice_4_28_11" id="label_4_28_11" class="gform-field-label gform-field-label--type-inline">Heart Attack</label>
</div>
<div class="gchoice gchoice_4_28_12">
<input class="gfield-choice-input" name="input_28.12" type="checkbox" value="Kidney Dysfunction" id="choice_4_28_12">
<label for="choice_4_28_12" id="label_4_28_12" class="gform-field-label gform-field-label--type-inline">Kidney Dysfunction</label>
</div>
<div class="gchoice gchoice_4_28_13">
<input class="gfield-choice-input" name="input_28.13" type="checkbox" value="Blood Clots" id="choice_4_28_13">
<label for="choice_4_28_13" id="label_4_28_13" class="gform-field-label gform-field-label--type-inline">Blood Clots</label>
</div>
<div class="gchoice gchoice_4_28_14">
<input class="gfield-choice-input" name="input_28.14" type="checkbox" value="Numbness" id="choice_4_28_14">
<label for="choice_4_28_14" id="label_4_28_14" class="gform-field-label gform-field-label--type-inline">Numbness</label>
</div>
<div class="gchoice gchoice_4_28_15">
<input class="gfield-choice-input" name="input_28.15" type="checkbox" value="Sprains or Strains" id="choice_4_28_15">
<label for="choice_4_28_15" id="label_4_28_15" class="gform-field-label gform-field-label--type-inline">Sprains or Strains</label>
</div>
<div class="gchoice gchoice_4_28_16">
<input class="gfield-choice-input" name="input_28.16" type="checkbox" value="None" id="choice_4_28_16">
<label for="choice_4_28_16" id="label_4_28_16" class="gform-field-label gform-field-label--type-inline">None</label>
</div>
</div>
</div>
</fieldset>
<div id="field_4_29" class="gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_4_29">
<h3 class="gsection_title">Massage Information</h3>
</div>
<fieldset id="field_4_30" class="gfield gfield--type-radio gfield--type-choice gfield--width-full field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_4_30">
<legend class="gfield_label gform-field-label">Have you had a professional massage before?</legend>
<div class="ginput_container ginput_container_radio">
<div class="gfield_radio" id="input_4_30">
<div class="gchoice gchoice_4_30_0">
<input class="gfield-choice-input" name="input_30" type="radio" value="Yes" id="choice_4_30_0" onchange="gformToggleRadioOther( this )">
<label for="choice_4_30_0" id="label_4_30_0" class="gform-field-label gform-field-label--type-inline">Yes</label>
</div>
<div class="gchoice gchoice_4_30_1">
<input class="gfield-choice-input" name="input_30" type="radio" value="No" id="choice_4_30_1" onchange="gformToggleRadioOther( this )">
<label for="choice_4_30_1" id="label_4_30_1" class="gform-field-label gform-field-label--type-inline">No</label>
</div>
</div>
</div>
</fieldset>
<fieldset id="field_4_67" class="gfield gfield--type-checkbox gfield--type-choice gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible"
data-js-reload="field_4_67">
<legend class="gfield_label gform-field-label gfield_label_before_complex">What type of massage are you seeking?<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></legend>
<div class="ginput_container ginput_container_checkbox">
<div class="gfield_checkbox" id="input_4_67">
<div class="gchoice gchoice_4_67_1">
<input class="gfield-choice-input" name="input_67.1" type="checkbox" value="Relaxation" id="choice_4_67_1">
<label for="choice_4_67_1" id="label_4_67_1" class="gform-field-label gform-field-label--type-inline">Relaxation</label>
</div>
<div class="gchoice gchoice_4_67_2">
<input class="gfield-choice-input" name="input_67.2" type="checkbox" value="Therapeutic/Deep Tissue" id="choice_4_67_2">
<label for="choice_4_67_2" id="label_4_67_2" class="gform-field-label gform-field-label--type-inline">Therapeutic/Deep Tissue</label>
</div>
<div class="gchoice gchoice_4_67_3">
<input class="gfield-choice-input" name="input_67.3" type="checkbox" value="Sports" id="choice_4_67_3">
<label for="choice_4_67_3" id="label_4_67_3" class="gform-field-label gform-field-label--type-inline">Sports</label>
</div>
<div class="gchoice gchoice_4_67_4">
<input class="gfield-choice-input" name="input_67.4" type="checkbox" value="Cupping" id="choice_4_67_4">
<label for="choice_4_67_4" id="label_4_67_4" class="gform-field-label gform-field-label--type-inline">Cupping</label>
</div>
<div class="gchoice gchoice_4_67_5">
<input class="gfield-choice-input" name="input_67.5" type="checkbox" value="Hot Stone" id="choice_4_67_5">
<label for="choice_4_67_5" id="label_4_67_5" class="gform-field-label gform-field-label--type-inline">Hot Stone</label>
</div>
<div class="gchoice gchoice_4_67_6">
<input class="gfield-choice-input" name="input_67.6" type="checkbox" value="Other" id="choice_4_67_6">
<label for="choice_4_67_6" id="label_4_67_6" class="gform-field-label gform-field-label--type-inline">Other</label>
</div>
</div>
</div>
</fieldset>
<div id="field_4_68" class="gfield gfield--type-text gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below hidden_label gfield_visibility_visible" data-js-reload="field_4_68"
data-conditional-logic="hidden" style="display: none;"><label class="gfield_label gform-field-label" for="input_4_68">Please describe:<span class="gfield_required"><span
class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_text"><input name="input_68" id="input_4_68" type="text" value="" class="large" placeholder="Other" aria-required="true" aria-invalid="false" disabled="disabled"> </div>
</div>
<div id="field_4_71" class="gfield gfield--type-text gfield--width-half field_sublabel_below gfield--no-description field_description_below gfield_visibility_hidden" data-js-reload="field_4_71">
<div class="admin-hidden-markup"><i class="gform-icon gform-icon--hidden"></i><span>Hidden</span></div><label class="gfield_label gform-field-label" for="input_4_71">Untitled</label>
<div class="ginput_container ginput_container_text"><input name="input_71" id="input_4_71" type="text" value="" class="large" aria-invalid="false"> </div>
</div>
<fieldset id="field_4_69" class="gfield gfield--type-checkbox gfield--type-choice gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible"
data-js-reload="field_4_69">
<legend class="gfield_label gform-field-label gfield_label_before_complex">What pressure do you prefer?<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></legend>
<div class="ginput_container ginput_container_checkbox">
<div class="gfield_checkbox" id="input_4_69">
<div class="gchoice gchoice_4_69_1">
<input class="gfield-choice-input" name="input_69.1" type="checkbox" value="Light" id="choice_4_69_1">
<label for="choice_4_69_1" id="label_4_69_1" class="gform-field-label gform-field-label--type-inline">Light</label>
</div>
<div class="gchoice gchoice_4_69_2">
<input class="gfield-choice-input" name="input_69.2" type="checkbox" value="Medium" id="choice_4_69_2">
<label for="choice_4_69_2" id="label_4_69_2" class="gform-field-label gform-field-label--type-inline">Medium</label>
</div>
<div class="gchoice gchoice_4_69_3">
<input class="gfield-choice-input" name="input_69.3" type="checkbox" value="Firm" id="choice_4_69_3">
<label for="choice_4_69_3" id="label_4_69_3" class="gform-field-label gform-field-label--type-inline">Firm</label>
</div>
<div class="gchoice gchoice_4_69_4">
<input class="gfield-choice-input" name="input_69.4" type="checkbox" value="Deep" id="choice_4_69_4">
<label for="choice_4_69_4" id="label_4_69_4" class="gform-field-label gform-field-label--type-inline">Deep</label>
</div>
</div>
</div>
</fieldset>
<fieldset id="field_4_33" class="gfield gfield--type-radio gfield--type-choice gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible"
data-js-reload="field_4_33">
<legend class="gfield_label gform-field-label">Do you have any allergies or sensitivities?<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></legend>
<div class="ginput_container ginput_container_radio">
<div class="gfield_radio" id="input_4_33">
<div class="gchoice gchoice_4_33_0">
<input class="gfield-choice-input" name="input_33" type="radio" value="Yes" id="choice_4_33_0" onchange="gformToggleRadioOther( this )">
<label for="choice_4_33_0" id="label_4_33_0" class="gform-field-label gform-field-label--type-inline">Yes</label>
</div>
<div class="gchoice gchoice_4_33_1">
<input class="gfield-choice-input" name="input_33" type="radio" value="No" id="choice_4_33_1" onchange="gformToggleRadioOther( this )">
<label for="choice_4_33_1" id="label_4_33_1" class="gform-field-label gform-field-label--type-inline">No</label>
</div>
</div>
</div>
</fieldset>
<div id="field_4_34" class="gfield gfield--type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below hidden_label gfield_visibility_visible" data-js-reload="field_4_34"
data-conditional-logic="hidden" style="display: none;"><label class="gfield_label gform-field-label" for="input_4_34">Please explain:<span class="gfield_required"><span
class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_text"><input name="input_34" id="input_4_34" type="text" value="" class="large" placeholder="Please explain:" aria-required="true" aria-invalid="false" disabled="disabled"> </div>
</div>
<fieldset id="field_4_36" class="gfield gfield--type-radio gfield--type-choice gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible"
data-js-reload="field_4_36">
<legend class="gfield_label gform-field-label">Are there any areas (feet, face, glute, pectoral, etc.) you do not want massaged?<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></legend>
<div class="ginput_container ginput_container_radio">
<div class="gfield_radio" id="input_4_36">
<div class="gchoice gchoice_4_36_0">
<input class="gfield-choice-input" name="input_36" type="radio" value="Yes" id="choice_4_36_0" onchange="gformToggleRadioOther( this )">
<label for="choice_4_36_0" id="label_4_36_0" class="gform-field-label gform-field-label--type-inline">Yes</label>
</div>
<div class="gchoice gchoice_4_36_1">
<input class="gfield-choice-input" name="input_36" type="radio" value="No" id="choice_4_36_1" onchange="gformToggleRadioOther( this )">
<label for="choice_4_36_1" id="label_4_36_1" class="gform-field-label gform-field-label--type-inline">No</label>
</div>
</div>
</div>
</fieldset>
<div id="field_4_35" class="gfield gfield--type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below hidden_label gfield_visibility_visible" data-js-reload="field_4_35"
data-conditional-logic="hidden" style="display: none;"><label class="gfield_label gform-field-label" for="input_4_35">Please explain:<span class="gfield_required"><span
class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_text"><input name="input_35" id="input_4_35" type="text" value="" class="large" placeholder="Please explain:" aria-required="true" aria-invalid="false" disabled="disabled"> </div>
</div>
<div id="field_4_70" class="gfield gfield--type-textarea gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_4_70"><label
class="gfield_label gform-field-label" for="input_4_70">What are your goals for this treatment session?<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_textarea"><textarea name="input_70" id="input_4_70" class="textarea small" placeholder="Explain in your own words..." aria-required="true" aria-invalid="false" rows="10" cols="50"></textarea>
</div>
</div>
<div id="field_4_40" class="gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_4_40">
<h3 class="gsection_title">By consenting, you confirm that the information you entered above is correct.</h3>
</div>
<fieldset id="field_4_59" class="gfield gfield--type-consent gfield--type-choice gfield--input-type-consent gfield--width-full field_sublabel_below gfield--no-description field_description_below hidden_label gfield_visibility_visible"
data-js-reload="field_4_59">
<legend class="gfield_label gform-field-label gfield_label_before_complex">Information Consent</legend>
<div class="ginput_container ginput_container_consent"><input name="input_59.1" id="input_4_59_1" type="checkbox" value="1" aria-invalid="false"> <label class="gform-field-label gform-field-label--type-inline gfield_consent_label"
for="input_4_59_1">I confirm the information entered above is correct</label><input type="hidden" name="input_59.2" value="I confirm the information entered above is correct" class="gform_hidden"><input type="hidden" name="input_59.3"
value="1" class="gform_hidden"></div>
</fieldset>
<fieldset id="field_4_60" class="gfield gfield--type-name gfield--width-half gfield_contains_required field_sublabel_hidden_label gfield--no-description field_description_below hidden_label gfield_visibility_visible"
data-js-reload="field_4_60">
<legend class="gfield_label gform-field-label gfield_label_before_complex">Your Full Name<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></legend>
<div class="ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name no_last_name no_suffix gf_name_has_1 ginput_container_name gform-grid-row" id="input_4_60">
<span id="input_4_60_3_container" class="name_first gform-grid-col gform-grid-col--size-auto">
<input type="text" name="input_60.3" id="input_4_60_3" value="" aria-required="true" placeholder="Enter your full name...">
<label for="input_4_60_3" class="gform-field-label gform-field-label--type-sub hidden_sub_label screen-reader-text">First</label>
</span>
</div>
</fieldset>
<div id="field_4_57" class="gfield gfield--type-text gfield--width-half field_sublabel_below gfield--no-description field_description_below gfield_visibility_hidden" data-js-reload="field_4_57">
<div class="admin-hidden-markup"><i class="gform-icon gform-icon--hidden"></i><span>Hidden</span></div><label class="gfield_label gform-field-label" for="input_4_57">Untitled</label>
<div class="ginput_container ginput_container_text"><input name="input_57" id="input_4_57" type="text" value="" class="large" aria-invalid="false"> </div>
</div>
<div id="field_4_62"
class="gfield gfield--type-date gfield--input-type-datepicker gfield--datepicker-default-icon gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below hidden_label gfield_visibility_visible"
data-js-reload="field_4_62"><label class="gfield_label gform-field-label" for="input_4_62">Date<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_date">
<input name="input_62" id="input_4_62" type="text" value="" class="datepicker gform-datepicker mdy datepicker_with_icon gdatepicker_with_icon hasDatepicker initialized" placeholder="Consent Date"
aria-describedby="input_4_62_date_format" aria-invalid="false" aria-required="true"><img class="ui-datepicker-trigger" src="https://recoverytimemassage.com/wp-content/plugins/gravityforms/images/datepicker/datepicker.svg"
alt="Select date" title="Select date">
<span id="input_4_62_date_format" class="screen-reader-text">MM slash DD slash YYYY</span>
</div>
<input type="hidden" id="gforms_calendar_icon_input_4_62" class="gform_hidden" value="https://recoverytimemassage.com/wp-content/plugins/gravityforms/images/datepicker/datepicker.svg">
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<h3 class="gsection_title">By consenting, you confirm that you have read and agree with the information listed above.</h3>
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<div id="field_4_45" class="gfield gfield--type-html gfield--width-full gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible"
data-js-reload="field_4_45">1) I give my permission to receive massage therapy.<br> 2) I understand that therapeutic massage is not a substitute for traditional medical treatment or medications.<br> 3) I understand that the massage
therapist does not diagnose illnesses or injuries, or prescribe medications.<br> 4) I have clearance from my physician to receive massage therapy.<br> 5) I understand the risks associated with massage therapy include, but are not limited
to:<br> • Superficial bruising<br> • Short-term muscle soreness<br> • Exacerbation of undiscovered injury <br><br> I therefore release the company and the individual massage therapist from all liability concerning these injuries that may
occur during the massage session.<br><br> 6) I understand the importance of informing my massage therapist of all medical conditions and medications I am taking, and to let the massage therapist know about any changes to these. I
understand that there may be additional risks based on my physical condition.<br> 7) I understand that it is my responsibility to inform my massage therapist of any discomfort I may feel during the massage session so he/she may adjust
accordingly.<br> 8) I understand that I or the massage therapist may terminate the session at any time.<br> 9) I have been given a chance to ask questions about the massage therapy session and my questions have been answered.</div>
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<h3 class="gsection_title">Recovery Time Massage LLC</h3>
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<p style="text-align: center; font-size: 24px;"><strong>Policy Agreement</strong></p><br> We appreciate that you’ve chosen us for your massage and bodywork needs. To provide the best service possible to our clients we have implemented the
following policies.<br>
<p style="text-align: center; font-size: 22px;"><strong>Cancellation Policy</strong></p><br> We respectfully ask that you provide us with a 24 hour notice of any schedule changes or cancellation requests. Please understand that when you
cancel or miss your appointment without providing a 24 hour notice we are often unable to fill that appointment time. This is an inconvenience to your therapist and also means our other clients miss the chance to receive services they
need. For this reason, you will be charged 50% of the service fee for each missed session, or for membership pre-paid massages the full service is lost and will not be reimbursed in anyway. We also reserve the right to require a credit
card number to be given to book future appointments so that appropriate fees may be charged if a late cancellation does occur. We understand that emergencies can arise and illnesses do occur at inopportune times. If you have a fever, a
known infection, or have experienced vomiting or diarrhea within 24 hours prior to your appointment time, we request that you cancel your session. Inclement weather may also result in the need for late cancellations. We will do our best
to give advanced notice if we are closing or need to cancel due to bad weather and we ask you to do the same. Please do not risk your own safety trying to make your appointment. Late cancellation due to emergency, illness, or inclement
weather will generally not result in any missed session charges, but this is determined on a case-by-case basis.<br>
<p style="text-align: center; font-size: 22px;"><strong>Late Arrival Policy</strong></p><br> We understand that issues can arise that may cause you to be late for your appointment. However, we ask that you call to inform us if this ever
occurs so we can do our best to accommodate you. Appointment times are reserved for each client, so oftentimes we cannot exceed that reserved time without making the next client late. For this reason, arriving after your appointment time
may result in loss of time from your massage so that your session ends at the scheduled time. Full service fees will be charged even when sessions are shortened due to late arrival. In return we will do our best to be on time, and if we
are unable to do so we will add time to your session to make up for our late arrival or adjust the service charge accordingly.<br>
<p style="text-align: center; font-size: 22px;"><strong>Inappropriate Behavior Policy</strong></p><br> Massage therapy is for relaxation and therapeutic purposes only. There is absolutely no sexual component to massage whatsoever. Any
insinuation, joke, gesture, conversation, or request otherwise will result in immediate termination of your session and a refusal of any and all services in the future. You will be charged the full service fee regardless of the length of
your session. Depending on the behavior exhibited we may also file a report with the local authorities if necessary. Treat your therapist with respect and dignity and you will be treated the same in return.
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<h3 class="gsection_title">By consenting, you agree to abide by the policies listed above.</h3>
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* Home * Products & Services * Products * Services * Membership Select Page * Home * Products & Services * Products * Services * Membership * Follow * Follow * Home * Products & Services * Products * Services * Membership * Home * Products & Services * Products * Services * Membership * Follow * Follow * Home * Products & Services * Products * Services * Membership * Home * Products & Services * Products * Services * Membership BEGIN YOUR RECOVERY PROCESS Massage Therapy Services in Charlotte NC Book An Appointment MASSAGE THERAPY SERVICES IN CHARLOTTE, SOUTH CHARLOTTE, INDIAN LAND, FORT MILL, BALLENTYNE AND PINEVILLE. At Recovery Time Massage of Charlotte, we mix relaxation and massage therapy to reach all your needs. Whether you’re experiencing life stressors or need pain relief from an injury, we can get to the source of your problem. We care about our client’s needs, and it shows in our sessions. We pay attention to detail in our bodywork for every client that enters our door. Give us a call for an assessment, and we’ll find the perfect clinical massage for you! We also offer Free Hot Stone and Cupping on all massages. Sometimes adding one of these to your massage can make the biggest difference in your recovery process! OUR FOCUS IS SIMPLE DEEP RELAXATION Massage therapy is a form of alternative medicine that involves the manipulation of soft tissue and joints to help relieve pain and muscle tension. Our hot stone massage therapy uses heated stones to create warmth on the body. The heat from the stones helps relax the muscles and soothes sore muscles. Our services are focused on healing and putting you in deep relaxation. Take a look at what we can offer you. View Services PAST CLIENT EXPERIENCES I used to think that getting a massage was for special occasions, but then someone gave me a gift of a massage with Morgan Bauer at Recovery Time Massage. It was the best massage I have ever had. For me it was very therapeutic and now I get a 2 hour massage from Morgan every two weeks. Gil Burnette Amazing experience! Morgan is super professional, all starting with getting an understanding of my goals for the massage the day before I arrived. I left there feeling like a new person and will definitely be returning on a regular basis! Doug C. Morgan is an excellent massage therapist. She listens to which areas I say are painful and she zeros in on those areas and thoroughly smooths them out. She innately knows the areas that need special attention and brings relief to these areas as well as relaxing your whole body. Her talents are amazing and she has helped me tremendously. I recommend her wholeheartedly. Michelle Read All Reviews "LET'S BEGIN YOUR RECOVERY JOURNEY" We have an array of services and memberships for your massage therapy needs. We look forward to hearing from you! View Memberships Recovery Time Massage 10643 Kettering D, 107 Charlotte, North Carolina 28226 (217) 254-5153 RecoveryTimeMassage@gmail.com Monday 9:00 am - 7:00 pm Tuesday 9:00 am - 7:00 pm Wednesday Closed Thursday: Closed Friday 9:00 am - 5:00 pm Saturday 9:00 am - 7:00 pm Sunday 9:00 am - 7:00 pm * Follow * Follow * Home * Products & Services * Membership © 2000 - 2019 YellowPageCity Inc. All Rights Reserved. Reproduction in whole or in part without permission is prohibited. Powered by YPC Media 10 Massage Hacks Enter your email address to receive a PDF on 10 Massage Hacks you MUST try before your next Recovery Time massage! Email(Required) CAPTCHA x NEW CLIENT FORM "*" indicates required fields 1Client Intake Form 2General Liability Release Form 3Policies PERSONAL INFORMATION Name* First Last Phone* Date of Birth* MM slash DD slash YYYY Email* Untitled* Address* Street Address City StateAlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Emergency Contact Name First Emergency Contact Phone # How Did You Hear About Us? MEDICAL INFORMATION Are you taking any medications?* Yes No Please List Name and Usage* Are you currently pregnant?* Yes No How far along?* Any high risk factors?* Do you suffer from chronic pain?* Yes No Please explain* What makes it better?* What makes it worse?* Have you had any orthopedic injuries?* Yes No Please list:* Please indicate any of the following that apply to you:* Cancer Headaches/Migraines Arthritis Diabetes Joint Replacement(s) High/Low Blood Pressure Neuropathy Fibromyalgia Stroke Heart Attack Kidney Dysfunction Blood Clots Numbness Sprains or Strains None MASSAGE INFORMATION Have you had a professional massage before? Yes No What type of massage are you seeking?* Relaxation Therapeutic/Deep Tissue Sports Cupping Hot Stone Other Please describe:* Hidden Untitled What pressure do you prefer?* Light Medium Firm Deep Do you have any allergies or sensitivities?* Yes No Please explain:* Are there any areas (feet, face, glute, pectoral, etc.) you do not want massaged?* Yes No Please explain:* What are your goals for this treatment session?* BY CONSENTING, YOU CONFIRM THAT THE INFORMATION YOU ENTERED ABOVE IS CORRECT. Information Consent I confirm the information entered above is correct Your Full Name* First Hidden Untitled Date* MM slash DD slash YYYY BY CONSENTING, YOU CONFIRM THAT YOU HAVE READ AND AGREE WITH THE INFORMATION LISTED ABOVE. 1) I give my permission to receive massage therapy. 2) I understand that therapeutic massage is not a substitute for traditional medical treatment or medications. 3) I understand that the massage therapist does not diagnose illnesses or injuries, or prescribe medications. 4) I have clearance from my physician to receive massage therapy. 5) I understand the risks associated with massage therapy include, but are not limited to: • Superficial bruising • Short-term muscle soreness • Exacerbation of undiscovered injury I therefore release the company and the individual massage therapist from all liability concerning these injuries that may occur during the massage session. 6) I understand the importance of informing my massage therapist of all medical conditions and medications I am taking, and to let the massage therapist know about any changes to these. I understand that there may be additional risks based on my physical condition. 7) I understand that it is my responsibility to inform my massage therapist of any discomfort I may feel during the massage session so he/she may adjust accordingly. 8) I understand that I or the massage therapist may terminate the session at any time. 9) I have been given a chance to ask questions about the massage therapy session and my questions have been answered. Information Consent I confirm I have read and agree with the information listed above Your Full Name* First Hidden Untitled Date* MM slash DD slash YYYY RECOVERY TIME MASSAGE LLC Policy Agreement We appreciate that you’ve chosen us for your massage and bodywork needs. To provide the best service possible to our clients we have implemented the following policies. Cancellation Policy We respectfully ask that you provide us with a 24 hour notice of any schedule changes or cancellation requests. Please understand that when you cancel or miss your appointment without providing a 24 hour notice we are often unable to fill that appointment time. This is an inconvenience to your therapist and also means our other clients miss the chance to receive services they need. For this reason, you will be charged 50% of the service fee for each missed session, or for membership pre-paid massages the full service is lost and will not be reimbursed in anyway. We also reserve the right to require a credit card number to be given to book future appointments so that appropriate fees may be charged if a late cancellation does occur. We understand that emergencies can arise and illnesses do occur at inopportune times. If you have a fever, a known infection, or have experienced vomiting or diarrhea within 24 hours prior to your appointment time, we request that you cancel your session. Inclement weather may also result in the need for late cancellations. We will do our best to give advanced notice if we are closing or need to cancel due to bad weather and we ask you to do the same. Please do not risk your own safety trying to make your appointment. Late cancellation due to emergency, illness, or inclement weather will generally not result in any missed session charges, but this is determined on a case-by-case basis. Late Arrival Policy We understand that issues can arise that may cause you to be late for your appointment. However, we ask that you call to inform us if this ever occurs so we can do our best to accommodate you. Appointment times are reserved for each client, so oftentimes we cannot exceed that reserved time without making the next client late. For this reason, arriving after your appointment time may result in loss of time from your massage so that your session ends at the scheduled time. Full service fees will be charged even when sessions are shortened due to late arrival. In return we will do our best to be on time, and if we are unable to do so we will add time to your session to make up for our late arrival or adjust the service charge accordingly. Inappropriate Behavior Policy Massage therapy is for relaxation and therapeutic purposes only. There is absolutely no sexual component to massage whatsoever. Any insinuation, joke, gesture, conversation, or request otherwise will result in immediate termination of your session and a refusal of any and all services in the future. You will be charged the full service fee regardless of the length of your session. Depending on the behavior exhibited we may also file a report with the local authorities if necessary. Treat your therapist with respect and dignity and you will be treated the same in return. BY CONSENTING, YOU AGREE TO ABIDE BY THE POLICIES LISTED ABOVE. Information Consent I confirm I have read and agree with the policies listed above Your Full Name* First Hidden Untitled Date* MM slash DD slash YYYY CAPTCHA x Notifications