• Client Record Card

  • Medical History

  • High/Low BP Pacemaker

  • Thrombosis/Veins Oedema Pain/Inflammation

  • Pregnant Post-Natal Cancer Covid 19

  • What is your skin type? Dry Normal Combination Oily Sensitive

  • How would you rate your stress levels? High Average Low

  • How often do you exercise? Daily 4- 5 days a week 1-3 days a week Never

  • I declare that the information I have given is correct. The treatment has been explained to me and I consent to treatment. I understand that close contact with people increases the risk of infection from COVID-19. By signing this form, I acknowledge that I am aware of the risks involved and give consent to receive massage from this practitioner. Practitioners must also alert clients of procedures related to possible exposure to COVID-19. I understand that my name and contact information might be shared with the NHS in the event that a client or practitioner tests positive for COVID-19. My contact details will only be shared in the event they are relevant based on suspected exposure date, and only for appropriate follow-up by the nhs.”

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