Schedule an Appointment

After you schedule an appointment, please review and complete the following forms:

Our sessions bring peace, joy, and happiness to my life every single time! Thank you, Roxann!
Angela W.

COVID STATEMENT: All Covid 19 protocols are still in place, and a mask is required to be worn during your session due to the close nature of our work. The health and safety of our clients and staff are our top priority. Thank you for understanding.

As of July 27, 2021, the CDC has recommended masks be worn inside by all regardless of their vaccination history.

Call us today at: 612-270-6323

HOURS:

Tuesday-Saturday by Appointment Only

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CLIENT FORMS:

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COVID-19 Pre-Screening

By attending my appointment…
I agree that I am not currently experiencing any of these symptoms:

  • Cough
  • Shortness of breath or difficulty breathing
  • Fever
  • Chills
  • Sore Throat
  • New loss of taste or smell

Please note: Other less common symptoms have been reported, including gastrointestinal symptoms like nausea, vomiting, or diarrhea. 

I agree that I have not:

  • Tested positive for COVID-19
  • Knowingly been exposed to someone with COVID-19
  • Recently Traveled to an area with a high infection rate
  • Been in an area where social distancing was not properly observed

If you have experienced any of the above, please reschedule your appointment at least 14 days from now.

If I have tested positive for Covid-19, have quarantined and recovered, I will have taken a Covid-19 test and have a negative result before going to the appointment.

If I have received vaccinations, I will provide vaccination dates to my practitioner at the time of appointment to be entered into my Health Chart.

COVID-19 Information & Liability Waiver

COVID-19 Information

Consent for Treatment

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 from receiving treatment at this time, I voluntarily agree to assume those risks, and I release and hold harmless the practitioner/business from any claims related thereto. I give my consent to receive treatment from this practitioner.

Typing your name in the box below represents your digital signature on this form.

Contact Us

Center for Life Design
684 Excelsior Blvd, Ste 120
Excelsior, MN 55331