Phone

979-353-1256

Email

tammy@uilleanmassage.com

Hours

Mon - Fri: 9AM - 6PM | Sat: 10AM-2PM

Intake Form

    Please be complete with your answers. The more we know about you, the better service we can provide. All fields are required. Put something in the field even if a question does not apply.

    First Name
    Last Name

    Date of Birth
    Phone
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    Returning Client YesNo
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    Additional Comments


    Please Read: Tammy Vaughn Consent Form
    By signing this consent form, I understand that Uillean Massage Therapy Center DOES NOT diagnose illness, disease or any other medical disorder. As such, Uillean Massage Therapy Center DOES NOT provide medical treatment or pharmaceuticals. I understand that any services provided are not a substitution for medical treatment and that I should see a physician for any physical ailment that I might have.

    Because Uillean Massage Therapy Center must be aware of any existing physical conditions, I have stated all my known medical conditions and take it upon myself to keep Uillean Massage Therapy Center updated on my physical health. Therefore, I assume all risk for my health and hold harmless Uillean Massage Therapy Center and Tammy Vaughn and any associated business entities, practitioners, Amenities or any persons involved in services performed.

    I also understand that any illicit or sexually suggestive remarks or advances made by me at any point will result in immediate termination of the session and in this case I will be held liable for payment “In full”.

    I acknowledge Uillean Massage Therapy Center maintains a 24 hours Cancellation policy. Thus, Uillean Massage Therapy Center has my authorization to keep my credit card on file in the event that I should cancel less than 24 hours prior to service date. If I choose to cancel services in less than 24 hours, I am responsible for the full amount of the service fees.

    I understand that questions about service procedures and recommendations are encouraged and welcomed.

    Full Legal Name
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