top of page

Health Assessment

The information requested below will assist us in providing you with safe treatments. Please ask your therapist if you have any questions about the information being requested.

 

All information provided below will be kept as confidential unless allowed or required by law. Your written permission will be required to release any information.

Have you been hospitalised in the last 12 months?
Are you suffering from a medical condition, illness, or injury?
Please tick all that apply
Please tick all that apply
Reason for seeking treatment
Preferred massage pressure

Thanks for submitting!

Our Treatment Forms

Pre Treatment

Post Treatment

bottom of page