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Kundala Massage Level 2 Client Intake Form

1. Client First and Last Name

2. Date

3. Pressure Preference: does it differ from area to area?

Light

Medium

Deep

4. On a scale from 1-5 what would you prefer?

1: A targeted, focused, structural massage.
5: A flowy, hypnotic, energetic massage.

5. Places to Avoid

None

Hair

Face

Feet

Other

If other, please list

6. Please specify skin conditions, past or current injuries that may interfere with the massage. If none, put NA

7. For our own marketing information how did you find out about us?

8. Glute Work: Is recommended and is standard in our services, but we wish to accomodate your comfort. Please specify what you would prefer

Glute Preference

Disclaimer
By checking each box and signing below, you agree to and understand the following:

What Level 2 Kundala Massage Is: A hypnotic, flowy style of massage that uses touch synced with rhythmic music to deliver a theraputic-tactile performance. While the client is laying face down, the Artist gets on the table and uses their legs and bodyweight, in addition to their arms and hands. Laying face up, the Artist perfoms a Kundala version of a Swedish massage and remains on the ground, only getting on the extension table to access the neck, head, and shoulders.

Music: Music during a Kundala Massage is more upbeat than traditional spa music. Its rhythmic tones act as a meduim for the Artist to flow, and is a highlight of each service. We use a large library of songs, some of which may contain adult language or themes. Regardless of content, all music is solely meant to aid in the artistry of the massage and should not be misinterpreted as anything else.

Draping: Our drape is a handmade piece you step into, that securely covers private areas while leaving everything else accessible. This minimal draping allows the Artist to move smoothly between muscle groups. Your Artist will demonstrate how to put it on. Multiple layers of towels are also used on the front for additional privacy. Individuals who identify as female will be covered with a towel on their chest, in addition to their provided coverings.

Proper Client Etiquette: Kundala Massage is an artform and should be treated and respected as such. As a client, you agree not to touch the Artist or engage in provocative behavior. Doing so is not only distracting to the Artist, is inappropriate and not welcomed. Unless you are adjusting to make yourself more comfortable, please keep your hands and body relaxed for the duration of the session.

Medical: Kundala Massage is not meant to replace medical advice or treatment. For advice or treatment outside the scope of massage, please refer to your physician.

Temperature and Oil: Our massage rooms are typically kept at 78-82 degrees Fahrenheit. When you are on the table, at the beginning of your session, please let your Artist know if you are uncomfortable with the temperature in any way. Additionally, during our massage services the Artists use a large amount of massage oils made of multiple types of seeds, nuts, and frruit. Please let us know if you have any allergies or sensitivities. Oil is notoriously difficult to get out of material. While you may feel slight oil residue, rest assured, they are diligently cleaned.

Communication: As a client, you agree to inform the Artist if you are in pain or uncomfortable at any point during the massage so the Artist can make proper adjustments.

Client Signature

Staff Only Below This Line

LMT Name

LMT Signature

Thanks for submitting!

Business Details

Contact

801-666-2997
Camilla@kundalamassage.com

Address

4885 south 900 east, Millcreek 84117

Opening Hours

Schedule may vary

10am-9pm Monday-Sunday

Social

Intake Forms

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