Welcome to Animal Bodywork and Aromatherapy. Please complete the client information sheet below, with waiver for all bodywork services including massage therapy, chiropractic, aromatherapy, and equine acupuncture. Please complete prior to your first appointment.

*Please note it is only necessary to provide one form per owner. Multiple animals may be listed below.

Medical History

Please list any chronic illnesses, lamenesses, allergies, or past surgeries.
Click or drag a file to this area to upload.
Do you have any information you would like us to review before your appointment? Feel free to upload it here.

Bodywork

*Please note all massage therapy appointments include thermal imaging, aromatherapy, and cold laser in the session.
Please indicate any sensitive areas or behavioral triggers we should be aware of during bodywork.
I hereby give Animal Bodywork and Aromatherapy permission to photograph my animal for the purposes of posting on social media channels.

I understand my personal information will remain private and will not be shared to the public with the exception of my animal's first name and image.
I understand that massage/ aromatherapy/ acupuncture/chiropractic work is not a substitute for medical treatment or medications, and that it is recommended that I work with my veterinarian for any medical conditions that my animal may have. I understand that Heather Wallace, or other non-veterinary personnel of Animal Bodywork and Aromatherapy cannot diagnose illness or prescribe medications. I understand that any information provided by the therapist is for educational purposes only, and is not diagnostically prescriptive in nature. I have listed all my animal’s known physical conditions, limitations, medical conditions and medications. It is my responsibility to update this information with the therapist and contact my veterinarian if my animal’s physical condition, limitations, medical condition or medications should change.

By signing this release, I consent to treatment for my animal and hereby release Heather Wallace, ESMT, CCMT and the independent contractors of Animal Bodywork & Aromatherapy from any and all liability, past, present and future, relating to the bodywork services provided at your request.