Intake Form

Please take a moment to complete our confidential, HIPAA compliant intake form before your appointment. You need only fill out the portions that you feel comfortable with disclosing. Full name is required.

If you need any assistance with it, please call us at 530-559-7172.

We thank you in advance for providing us with your health history so we may provide you with the best care possible!


Your intake form must be completed before receiving any services at Vela Massage Retreat. 

If this is not completed before your appointment time, you must arrive 20 minutes early or your service time may be shortened to accommodate this.