Intake forms

To better customize our treatment to your needs all forms must be completely filled out prior to the first session. Print out a copy of the intake form from the link below. Then, mail them to Samantha's mailing address along with a check for $130 - 150.00 prior to your scheduled appointment. Make copies and bring with you, in case USPS fails to deliver. Thank you.

Click here to download Intake Form - PDF

Click here to download San Francisco Bayarea Financial Agreement - PDF

Click here to download Anatomy Indicator - PDF

Send check / money order and intake forms to:
Samantha Ford
PO Box 6684
Albany, CA 94706
USA

OR

Mail intake forms and pay via credit card to:
Link to access Pay Pal*
Pay to email address: earthdancer@earthdancermassage.com
*Pay Pal payments: Add 3.5% to total