Eastside Medical Massage
Licensed Massage Practitioner in Bellevue

Raising the bar for pain relief and enhanced health through massage therapy
Serving Bellevue, Kirkland, Redmond, Mercer Island, Issaquah, Woodinville, Kenmore, Seattle...

See me at Crossroads Wellness - 15821 NE 8th Street, Suite 100, Bellevue WA 98008
 

Call (206) 396-8452

 

Washington State
Department of Health
Massage Practitioner License
# MA 60197801
 

 
Coming Soon:  What is Massage Therapy, Getting Pain Relief, Wonderful Swedish Massage, What is Sports Massage, Deep Tissue Massages and In Home Massage
 

The Forms


If your schedule is tight and you don't have time to arrive at your appointment 15 minutes early to fill out paperwork, you can get your paperwork right here!

 

I'll need a completed copy of forms #1 and #2 below before we can begin your trip down the road to wellness. If you are coming to me with a doctor's prescription for massage, I'll also need a copy of form #3 that you have printed and had your prescribing doctor complete and sign.

 

These forms are in PDF format and require that you have Adobe Acrobat Reader or the faster, 5-star rated Sumatra PDF Reader installed on your computer. Both programs are free.

 

Get Adobe Acrobat Reader HERE. Get Sumatra PDF Reader HERE.

 

Then please click these links to download your forms:

 

  1. Health Information Form
  2. HIPAA Notice of Privacy Practices Form
  3. Therapist Prescription Form

 

Once I have your completed forms, we can start the important work of restoring your wellness through therapeutic massage, which will look something like this:

 

 

 

 

Experience what real relief is all about »

Did You Know?


From time to time, Mark Wallace stays on his own road to wellness by exchanging therapeutic massages with his colleagues.

 

We are currently updating our testimonials from clients, doctors and other massage therapists. Bellevue, Seattle, Issaquah and many other locales are home to colleagues whose testimonials will soon appear on our Testimonials page. Check back often to see what clients and professionals have to say about Mark's therapeutic massage work!

 

 

Experience what real relief is all about »

Home  ::  As Your Massage Therapist...  ::  Massage Services  ::  Forms  ::  Testimonials  ::  Make an Appointment  ::  Contact Mark
 

     See My Therapeutic Massage Profile Page on LinkedIn!     Visit My 'Pain Relief Through Massage Therapy' Profile Page     Menber of the American Massage Therapy Association     

 

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