Consultation form updated

Treatments
Client Name
Date
DOB
Phone
email
example@example.com
address
GP name & Address
GP Phone number
Do you currently have any of the following conditions?
Diabetes Yes/No.
High / low blood pressure Yes/No.
Cancer Yes/No.
Varicose veins Yes/No
Epilepsy Yes/No
Pregnancy Yes/No
Breathing disorder Yes/No
Heart condition Yes/No
Claustrophobia Yes/No
Allergy Yes/No
Fungal conditions Yes/No
Infectious diseases Yes/No
Skin disorders Yes/No
Any recent surgery Yes/No
Open Cut Yes/No
Sore OR wounds Yes/No
Any other medical condition Yes/No
Any current medication may prevent you having this treatment? Yes /NO
If you have answered yes to any of the above, please provide details below? _________________
Joint problems Yes/No
What are your goals for this treatment session?
Client Declaration
I declare that the information that I have given is true and correct and give my consent for
Clients Signature:

Clear
Date:

MonthDayYear
Date
Policy Notification
We appreciate that you’ve chosen Farzana’s Beauty for your massage and. To provide the best service possible to our clients we have implemented the following policies.
Service Deposit / Cancellation Policy
Any services over £60 or 2 hours longer require a deposit of 25% deposit are non-refundable. We respectfully ask that you provide us with a 24-hour notice of any schedule changes or cancellation requests. Failure to provide 24-hour notice for cancellation will result in loss of deposit.
Late Arrival Policy
We request that you arrive 5-10 minutes prior to your appointment time to allow time to fill out any required paperwork as well as answer any intake questions your therapist may have.
Inappropriate Behaviour Policy
During your treatments please ensure There is no inappropriate behaver, conversation, or request, otherwise it will result in immediate termination of your session and a refusal of any and all services in the future.
Client's Signature:

Clear
Date:

MonthDayYear
Should be Empty:

Client Declaration

Policy Notification

Service Deposit / Cancellation Policy

Late Arrival Policy

Inappropriate Behaviour Policy