Forms

Please print and fill out the information sheet

and present it to Don at your first massage appointment.

This will save you time.

If your physician is referring you to Massage by Don,

please print and fill out the Physician Referral Form

and have it signed by your physician. We can print

you a receipt for a medical massage.

If you have had surgery in the past year, Don may need

to have permission from your physician to do bodywork

or give a massage. Please print out the physician permission

sheet and have your doctor sign.

The body map will be completed by Don and kept in

your massage file.