Cliff Seretan, MS, LMT-DPI
Therapeutic Care and Wellness Massage, Operated by Different Planes, Inc.
Client Forms

Below are links to various massage/bodywork forms. They are intended to both speed the intake process, provide more time on the table and inform the client.

Prior to the first visit, please take the time to complete and print out the Health Information form. In subsequent visits, should your health status change, please complete the Health Status Update form.

The Body Map for Clients can help to precisely communicate the areas of pain or discomfort, so the practitioner may better help the client achieve the best results from the session.

Should a doctor's permission be prudent or required, due to an existing condition, please complete the Physician's Permission form.

Any time you have received services and wish to provide comment, please feel free to fill out a Client Feedback form. Be sure to let us know if we may share the comments with others, via this website and/or elsewhere.

Thank you for taking the time to work with us to improve your massage/bodywork experience.

Health Information form
Screening Questionnaire form
Body Map for Clients
Health Status Update form
Client Feedback form
Physician's Permission form
Physician's Referral form

Associated Bodywork & Massage Professionals
© Copyright 2025 Cliff Seretan, MS, LMT-DPI. All rights reserved.