I am frequently asked what does the short consultation I give at the beginning of a massage session cover and why do I need to give one.
The reason I need to give one is pretty simple - Putting aside the fact that my insurance would be void otherwise, I give a consultation for your safety and to benefit your health. Although essential oils and massage are totally safe when administered professionally by a qualified therapist, there are certain contraindications that require special attention. Regardless of how happy the ending may be, if you go for a massage and the therapist does not give you a consultation you need to be asking yourself why not, and do they really have my safety in mind!!
All your information is subject to data protection and should be treated in the strictest confidence. So there is no reason not to be doing a consultation especially as it only takes a moment to complete. See for yourself below:
Date of Initial Consultation: Client reference number:
Massage Consultation Form
General Client Information
Name: D.O.B.:
Tel: Email:
Do you suffer from any of the following conditions:
Epilepsy
Diabetes
Asthma
Heart condition
High or low blood pressure
Circulatory disorder
Thrombosis
Recent haemorrhage or swelling
Varicose veins
Skin disorder
Abdominal complaint
Dysfunction of the nervous system
Recent operation
A potentially fatal or terminal condition
Are you currently under GP/ Hospital care? Yes/No
If yes, please give details below:
Treatment: Medication:
Do you suffer from any nervous or stress related problems?
Do you suffer from any of the following urinary problems?
Do you suffer from any of the following digestive problems?
Do you suffer from any of the following respiratory problems?
Do you suffer from any of the following circulation problems?
Do you suffer from any of the following skin complaints?
How would you describe your Sleep pattern:
Restless/Excellent sleep/Waking for bathroom
Would you consider your stress levels to be
Average/High/Low
Would you say your energy levels are
Average/High/Low
Please give details of your typical daily diet:
Type of exercise taken:
Do you smoke? If so how many per day?
Weekly alcohol intake (units):
Are you currently having any complementary treatment?
Have you tried aromatherapy or any other complementary therapies before?
In order of priority, please list any issues that you would like treated during the sessions.
Issue 1: Issue 2: Issue 3:
Client signature:
Therapist’s signature:
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