Dori White Massage & Cupping
  • Home
  • About
  • Services
    • Relaxation & Rejuvination
    • Cupping Therapy
    • Deep Tissue Massage Combined Therapies
    • Swedish Massage Therapy
  • Gifts
  • Contact
  • Appointments COVID-19
  • Reviews

    New Patient Intake Form                                   Dori White Massage & Cupping Therapy 

    Please choose one of the following options.

    Mark all that apply below
    Please list any medications, vitamins or supplements you use and what you use them for.
    If you answered YES to #2
    I understand that the above information will be kept in strict confidence and is provided to Dori White LMT in order to receive the best possible care and service.  I understand that Dori makes no medical claims and is not liable for any injury, health impairment or accident that may occur during my treatment.  

    24-Hour cancellation notice is required to avoid paying no show fees of half your scheduled appointment amount.

    "No-Shows" are charged the full amount of the missed appointment

    Late Arrivals , your session may need to be shortened to accommodate other clients who have made appointments.  You will be charged for a full session.

    Returned Check Policy, you will be charged $35.00 NSF fee.
    Thank you so much for selecting me as your massage therapist.  I look forward to meeting and working with you.
    Dori White, LMT
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Cupping Therapy and Massage Therapy

Dori White Massage & Cupping Therapy

Phone (503) 957-3696

Rediscover Your Healthy, Pain-Free Body!

Providing Massage Therapy for over 20 years, has been awarded "Best in Portland", offering several massage modalities. Specializing in  Cupping Therapy, Deep Tissue Massage Therapy, Motor Vehicle Injury R
ehabilitation, Myofascial Release, Trigger Point Therapy, Swedish Massage, Relaxation Massage, and more.

Dori White has been a Portland Massage Therapist offering massage therapy since 1998.   Lic. #6904
  • Home
  • About
  • Services
    • Relaxation & Rejuvination
    • Cupping Therapy
    • Deep Tissue Massage Combined Therapies
    • Swedish Massage Therapy
  • Gifts
  • Contact
  • Appointments COVID-19
  • Reviews