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Intake Form

Welcome to Bodied Boss Studio! Please complete this intake form as thoroughly and honestly as possible. Your responses help us personalize your non-invasive body contouring experience and make sure your treatment is safe and effective. All information is kept confidential.

Preferred contact method
Email
Phone
Text
Have you had body sculpting before?
Yes
No
Are you currently pregnant or nursing?
Yes
No
Do you have a pacemaker or metal implants?
Yes
No
Do you have a history of blood clots?
Yes
No
Do you have heart disease, diabetes, or high blood pressure?
Yes
No
Do you have any liver, kidney, or lymphatic disorders?
Yes
No
Do you have any active infections, skin conditions, or open wounds?
Yes
No
Have you recently had surgery?
Yes
No
Have you had any cosmetic or aesthetic procedures in the last 30 days?
Yes
No
Have you had Botox, fillers, surgery, or laser treatments recently?
Yes
No
Do you bruise easily?
Yes
No
Do you have swelling, inflammation, or circulation issues?
Yes
No
Do you have a history of hernias in the treatment area?
Yes
No
Have you ever had adverse reactions to body sculpting treatments?
Yes
No
Have you had lymphatic drainage or detox treatments before?
Yes
No
Do you smoke or vape?
Yes
No
Do you drink alcohol regularly?
Yes
No
Are you willing to follow post-treatment instructions?
Yes
No
Are you willing to maintain results with hydration, nutrition, and movement?
Yes
No
Have you read and understood the treatment contraindications?
Yes
No
Do you understand results vary by client?
Yes
No
Do you understand this is a non-surgical treatment and not a substitute for medical care?
Yes
No
Have you disclosed all relevant health information?
Yes
No
Do you consent to the treatment and potential side effects?
Yes
No
Do you understand you may need multiple sessions for best results?
Yes
No
Do you want package pricing or a single session?
Package pricing
Single session
Do you want to receive promotional texts or emails?
Yes
No
Before/after photo consent
Yes
No
Membership interest
Yes
No
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