Bodywork | Client Registration

Bodywork Services

Client Registration
I want to thank you for your trust and willingness to be open to experiencing something new, and for allowing me to guide you on your journey of healing and self exploration. I am truly honoured to do this sacred and necessary work.

With gratitude, I ask that you please complete the following Client Registration at your earliest convenience. This form will need to be completed in ONE sitting as the form does not auto-save your answers. Please set aside approximately 15 minutes to ensure that you can provide me with the most comprehensive and all-encompassing information, so that I might best serve you during the course of our working relationship.

By initialling each section and electronically signing your name and the date upon completion, you are acknowledging that the information you have provided is true and correct. Seasons of Womanhood respects your right to privacy and assures you that all answers are kept confidential unless otherwise required by law.
Contact Information
Your Full Name*

First NameLast Name
Your Date of Birth*

DayMonthYear
Date
Your Occupation*
eg. lawyer, nurse, retail assistant, stay-at-home mum, small business owner etc
Your Mobile Phone Number*

Area CodePhone Number
Your Email*
example@example.com
Your Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Your Emergency Contact Person's Name
If applicable
Your Emergency Contact Person's Mobile Phone

Area CodePhone Number
Your Initials*

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Please select which bodywork applies to your booking

Pelvic CareWomb CareLymphatic Detox MassageAbdominal Scar ReleasePregnancy Massage
Pelvic Care

Health history and considerations
To recap what Internal Pelvic Release work entails:
- It is a form of body work for the female pelvis;
- It involves gentle, but deliberate touch of the intravaginal tissues to support the softening (or releasing) of ligaments, muscles and fascia within the pelvic space;
- It aims to connect, or reconnect us with our internal tissues and bony structures within our pelvis;
- It works to release stored tension, and helps to create relaxation within our pelvic cavity;
- It allows for better blood circulation and energetic flow to our pelvic region.
You might benefit from receiving Internal Pelvic Release work if you:
- Want to prepare your body for conception;
- Want to ready your pelvis for the expansion of birth;
- Want to support your body’s recovery in the postpartum period (for both vaginal and caesarean birth mamas);
- Want to support your healing from pelvic trauma and pain (both physically and emotionally);
- You want to reestablish sensation and pleasure within your pelvic space;
- Want to explore the landscape of your pelvis with the help of a loving and caring sister (Me!).
Below are just a few questions to provide me with details about yourself, any history that may be relevant, and what you’re hoping to receive from this work. If you have any questions before or after our session, please don’t hesitate to send me an email.
What is your primary reason for seeking pelvic care?*
What are you hoping to gain from our session together?*
Do you have any physical, psychological, emotional, spiritual or cultural considerations that may be relevant to our session?*
Do you have any history of sexual abuse or trauma?*
Please indicate if any of the following contraindications apply:*

Actively trying to conceive (Session booked post ovulation)Actively receiving fertility treatment eg. IVF (Please discuss with me)Bleed due within two days of your session (To the best of your knowledge)Current heavy menstrual bleedingCurrently pregnant < 24 weeks gestationCurrently pregnant with a high risk pregnancyIUD currently insitu (Please discuss with me)Recent abdominal or pelvic surgery (Within the last 3-6 months)None of the above apply
Please select all that may apply to your womb/reproductive history:*

Bicornuate UterusEndometriosisFertility issuesHeavy bleedsIrregular bleedsPainful bleedsPainful ovulationPoly cystic ovarian syndromeRecurrent miscarriageSpotting between bleedsUterine fibroids or polyps*I no longer have a menstrual cycle*I no longer have a womb/ovaries/cervixNone of the above apply
Please indicate if any of the following pelvic organ/pelvic floor conditions apply to you:*

Cervical dysplasiaChronic/recurrent candida, bacterial vaginosis, or pelvic inflammatory diseaseChronic/recurrent urinary tract infectionsDiagnosed pelvic organ ptosis or prolapseDyspareunia or painful sexual intercourseFaecal incontinence or dysfunction (Including chronic constipation/diarrhoea)History of third or fourth degree perineal tearsPartial or full hysterectomyVaginismusVulvodynia (chronic pain/discomfort around the opening of the vagina)Urinary incontinence or dysfunctionNone of the above apply
Please indicate if any of the following apply to your medical history*

Abdominal, pelvic or lower back surgeryAccidents or trauma (physically or emotionally)Falls or injuries to your head, neck, sacrum, coccyx (tailbone) or backNone of the above applyOther
Have you ever been pregnant, and if so please provide details of your experience/s:*
Including how many times you've given birth, what method/s of birth, and if you had any trauma associated
If you know the story of your own birth, how do you feel in regards to how you entered the world?*
This relates to how you were born by your own mother
Your Initials

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Womb Care

Health history and considerations
To recap what a Womb Hara Massage entails:
- It is a blend of ancient bodywork practices for the female abdomen, womb and pelvis created by Natalie Zukerman;
- A fusion of Chinese Chi Nei Tsang abdominal massage, fertility massage, and Hawaiian Lomi Lomi massage techniques with sacred feminine rituals;
- It aims to connect, or reconnect us with our abdomen, womb space, pelvis, and all the magic that is held within;
- It works to release stored tension, and helps to create relaxation throughout our whole body;
- It allows for better blood circulation and energetic flow to our abdomen, womb space and pelvic cavity.
You might benefit from receiving a Womb Hara Massage work if you:
- Want to prepare your body for conception by inviting flow and pleasure back to your womb space;
- Want to support your body to release any heavy emotions, sadness, grief or anger following an early birth (miscarriage) or termination/abortion;
- Want to support your body in the early postpartum period (for both vaginal and caesarean birth mamas) by providing nourishing, gentle touch to support optimal healing and return of essential life force energy;
- Are experiencing fertility challenges such as delayed or absent ovulation or menstruation;
- Are experiencing menstrual cycle concerns and you want to support your womb into optimal alignment;
- Are traversing peri-menopause or menopause and you want to provide attention and care to your womb space to ease unwanted symptoms;
- Have recently experienced a significant life event (eg. a breakup/divorce, death of a loved one) and you want to release stored trauma and support the body to move through grief;
- Have recently experienced a physical injury to the abdomen, pelvis or hips eg. a fall, post surgery;
- Want to ease digestive issues and want to increase flow and ease within the digestive system;
- Are at point in your life where you are feeling called to experience a nervous system rebirth.
Below are just a few questions to provide me with details about yourself, any history that may be relevant, and what you’re hoping to receive from this work. If you have any questions before or after our session, please don’t hesitate to send me an email.
What is your primary reason for seeking womb care?*
What are you hoping to gain from our session together?*
Do you have any physical, psychological, emotional, spiritual or cultural considerations that may be relevant to our session?*
Do you have any history of sexual abuse or trauma?*
Please indicate if any of the following contraindications apply:*

Actively trying to conceive (Session booked post ovulation)Actively receiving fertility treatment eg. IVF (Please discuss with me)Bleed due within two days of your session (To the best of your knowledge)Current heaving menstrual bleedingPossibility of pregnancyIUD currently insitu (Please discuss with me)Recent abdominal or pelvic surgery (Within the last 3-6 months)None of the above apply
Please select all that may apply to your womb/reproductive history:*

Bicornuate UterusEndometriosisFertility issuesHeavy bleedsIrregular bleedsPainful bleedsPainful ovulationPoly cystic ovarian syndromeRecurrent miscarriageSpotting between bleedsUterine fibroids or polyps*I no longer have a menstrual cycle*I no longer have a womb/ovaries/cervixNone of the above apply
Please indicate if any of the following apply to your medical history:*

Abdominal, pelvic or lower back historyAccidents or traumas (Physically or emotionally)Falls or injuries to your head, neck, sacrum, coccyx (tailbone) or backNone of the above applyOther
Please indicate if any of the following apply to your digestive health:*

Abdominal painConstipation (<1 stool movements per day)Chrones DiseaseDiarrhoeaIrritable Bowel SyndromeIssues with organs of the digestive system*None of the above applyOther
Please indicate where within your abdomen you experience pain or discomfort:*

123456789101112*I don not feel any pain or discomfort
Have you ever been pregnant, and if so please provide details of your experience/s:*
Including how many times you've been pregnant, given birth, what method/s or birth, and if you had any trauma associated
If you know the story of your own birth, how do you feel in regards to how you entered the world?*
This relates to how you were born by your own mother
PLEASE NOTE: Womb Hara Massage is contraindicated during pregnancy. But don't worry, save this ceremony for your early postpartum instead, and nourish all the hard work your body has done to bring your little one Earthside! If you are currently pregnant and you're looking for an appropriate bodywork to support your on your journey, check out my pregnancy massage and lymphatic detox massage offerings.
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Lymphatic Detox Massage

Health history and considerations
To recap what Lymphatic Detox Massage entails:
- It is a dynamic massage technique created by remedial massage therapist Jessie Whittaker;
- It is a form of body work that stimulates the lymphatic system;
- It combines lymphatic, rhythmic strokes and sports massage techniques to drain, reduce inflammation, promote flow and decrease pain;
- It aims to release tightness/tension/adhesions within the fascia to create movement within the tissues;
- It works to shift congestion, create relaxation, allows for better blood circulation and energetic flow to throughout the whole body.
This treatment can be performed at any season of life, and is the perfect way to support you during pregnancy and early postpartum.

You might benefit from receiving Lymphatic Detox Massage if you're looking to:
- Improve detoxification by stimulating the flow of lymph (fluid) within the body;
- Support healthy immune function by enhancing lymphatic circulation;
- Reduce swelling and pain caused by lymphatic congestion, pooling of fluid and inflammation (especially helpful in pregnancy);
- Enhance healing of damaged cells/tissues by increased flow and circulation (perfect for supporting postpartum healing);
- Improve skin health by increasing blood flow and clear cellular waste;
- Support weight loss by promoting the elimination of toxins and excess fluid;
- Alleviate pain, stiffness and inflammation associated with chronic conditions through gentle bodywork;
- Promote relaxation and stress reduction through gentle, rhythmic movements and the stimulation of the vagus nerve.
Below are just a few questions to provide me with details about yourself, any history that may be relevant, and what you’re hoping to receive from this work. If you have any questions before or after our session, please don’t hesitate to send me an email.
Have you ever received Lymphatic Massage?*

YesNo
If yes please indicate when:
Have you ever received any other forms of massage/bodywork?*

YesNo
If yes please indicate when and what modality:
What is your primary reason for seeking Lymphatic Detox Massage?*
What are you hoping to gain from our session together?*
Please indicate if any of the following contraindications apply:*

Active feverAcute inflammationActive infectionActive cancer (Clearance required from oncologist)Cardiovascular conditions (Please contact me)Current blood clot/DVT/PEHigh blood pressure (Please contact me)Implants and prosthetics (Please contact me)Kidney failureOsteoporosis (Please contact me)Pregnancy in the first trimester (LDM safe from second trimester onwards)Recent surgery (Within the last 3 months)None of the above apply
Please indicate if any of the following apply to your medical history:*

Accidents or traumas (Physically or emotionally)Falls or injuries to your head, neck, pelvis or backPain, bruising or swellingPrevious pregnancies/birthsRegular use of prescribed medicationsSurgical proceduresNone of the above applyOther
If any of the above apply, please provide details below:
Do you have any physical, psychological, emotional, spiritual or cultural considerations that may be relevant to our session?*
Your Initials*

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Abdominal Scar Release

Health history and considerations
To recap what the Abdominal Scar Release technique entails:
- It is a blend of bodywork practices for the female abdomen and pelvis created by Myotherapist Madelaine Longrigg;
- It is designed to support women who have abdominal scars from surgery such as caesarean section, gynaecological laparoscopy/laparotomy, and hysterectomy;
- A fusion of nurturing therapeutic touch, combined with fascial techniques to release tension, promote tissue regeneration, and restore mobility;
- It aims to connect, or reconnect you with your abdomen, womb space and pelvis, while supporting you to process the stories connected to your scar/s;
- It allows for better blood circulation and energetic flow to our abdomen, womb space and pelvic cavity.
This treatment can be performed at any season of life, and is a gentle and nurturing way to integrate and heal - both physically and emotionally - after abdominal surgery.

You might benefit from receiving Abdominal Scar Release if you're looking to:
- Deeply connect with your breath and it's potential for healing;
- Mobilise adhesions around the ribs, diaphragm, abdominal wall, and scar;
- Ease pain, discomfort or sensations that your scar is 'stuck/sticky';
- Reconnect with areas of numbness, tingling or lack of sensation;
- Reduce back, hip, and pelvic pain associated with core dysfunction;
- Ease tension within the abdomen that can contribute to pelvic floor dysfunction;
- Explore and heal any negative/unwanted emotions linked to your scar/s.
Below are just a few questions to provide me with details about yourself, any history that may be relevant, and what you’re hoping to receive from this work. If you have any questions before or after our session, please don’t hesitate to send me an email.
Please indicate all forms of abdominal surgery that apply to your history?*

AbdominoplastyCaesarean section (Single)Caesarean section (Multiple)Caesarean section - classical incisionCancer/tumour removalHysterectomy - abdominalHysterectomy - vaginalLaparoscopy/laparotomyMyomectomy (Fibroid removal)Other
How long ago did you have your surgery/surgeries?*
Please provide all known dates for any abdominal surgeries you've had
How was your scar healing process immediately post surgery?*
Please detail whether you had any infections, periods of immobility, specialised wound dressings used etc.
Have you ever received any kind of scar release work before?*

YesNo
If yes, please indicate when and what treatments have worked for you:
What is your primary reason for seeking Abdominal Scar Release?*
What are you hoping to gain from our session together?*
Please indicate if any of the following contraindications apply:*

Abdominal surgery within the last 8 weeksAbdominal mesh (Commonly used during Hernia repair surgery)Active fever, inflammation or infection presentOpen scarring (Wound not fully healed)Pregnancy in the first trimesterNone of the above apply
Are you currently experiencing any type of back, hip or abdominal pain?*

YesNo
Do you have any movements that are restrictive/causing you pain?*

YesNo
If yes, please provide where you feel this below:
Do you have any difficulties breathing?*

YesNo
Do you have any other scars on your body apart from those you are seeking scar release therapy for?*

YesNo
If yes, please indicate where on your body below:
Regardless of how long ago the trauma was sustained
Have you ever given birth before?*

YesNo
If yes, please provide birth details below:
Including early births/miscarriages/terminations and gestation of pregnancy
Do you have any degree of incontinence or have any level of pelvic floor/pelvic organ dysfunction?*

YesNo
Do you have or feel that you have any degree of Diastasis Recti?*

YesNo
Do you have a daily bowel motion?*

YesNo
If not, please provide how often you move your bowels below:
Including early births/miscarriages/terminations and gestation of pregnancy
Do you have any skin rashes, open/unhealed wounds or bruises on your abdomen?*

YesNo
Do you have any physical, psychological, emotional, spiritual or cultural considerations that may be relevant to our session?*
Do you have any trauma/stress/anxiety associated with your scar/s?*
Your Initials*

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Pregnancy Massage

Health history and considerations
To recap what the Pregnancy Massage technique entails:
- A fusion of Swedish Massage techniques, along with trigger point release, fascial release, and breathwork practises to provide a whole body relaxation treatment;
- It has been practised cross-culturally for as long as massage has been documented;
- A holistic and gentle way to support you to have a healthy and enjoyable pregnancy;
- It allows for better blood circulation and energetic flow to our abdomen, womb space and pelvic cavity;
- When performed regularly, pregnancy massage is a simple way to help nourish your wellbeing and strengthen your inner resources for birth and beyond.
This treatment has been designed to support women from the first trimester* right through to birth.

You might benefit from receiving Pregnancy Massage if you're looking to:
- Ease muscular aches/pains associated with a growing body;
- Relieve stress and anxiety held within the tissues;
- Reduce oedema and swelling in the extremities;
- Increase blood flow for better oxygenation;
- Improve sleep comfort and quality;
- Promote relaxation and improve mental wellbeing;
- Reduce tension and allow for better physical and energetic flow;
- Support the Mother-Baby connection.
Each session is tailored to your individual needs/concerns for your current stage of pregnancy. The massage will be performed in a combination of supported side-lying and semi-reclined positions - allowing for optimal comfort for both you and your growing baby.

Below are just a few questions to provide me with details about yourself, any history that may be relevant, and what you’re hoping to receive from this work. If you have any questions before or after our session, please don’t hesitate to send me an email.
What is your birth guess date (EDB)?*

DayMonthYear
If unknown please provide an estimated month (end of month)
What number pregnancy and birth will this be for you?*
Please include all previous pregnancies/births you have experienced including early births/miscarriages/terminations
Have you ever received a Pregnancy Massage before?*

YesNo
If yes, please indicate when below
Have you received any other form of massage/bodywork during this pregnancy?*

YesNo
If yes, please indicate what modality and when below
What is your primary reason for receiving Pregnancy Massage?*
What are you hoping to gain from our session together?*
Please indicate if any of the following contraindications/risks apply to your current pregnancy:*

Assisted-conception pregnancy (eg. IUI, IVF)Active fever or infectionCurrent abdominal painHistory of bleeding in this pregnancy (Please contact me)High blood pressure/Pre-eclampsia (Please contact me)High-risk/complicated pregnancy (Medical clearance required)Multiples pregnancy (eg. twins/triplets)Nausea or hyperemesis gravidarum (Modifications will be made)Pregnancy in the first trimester (Modifications will be made)Type 1/Type 2/Gestational Diabetes (Modifications will be made)*None of the above apply
Please indicate if any of the following apply to your birthing history:*

Early birth/miscarriage (Massage contraindicated in the first trimester)Complications in previous birth/sPlacental abruption in previous pregnancyPreterm birth in previous pregnancyPre-eclampsia/Eclampsia/HELLP syndrome in previous pregnancyStillbirth in previous pregnancy*None of the above apply
If any of the above apply, please provide details below
Please indicate if any of the following apply to your medical history:*

Accidents or traumas (Physically or emotionally)Falls or injuries to your head, neck, pelvic, sacrum, coccyx (tailbone) or backPre-existing high risk medical condition prior to pregnancy eg. cardiac diseaseRegular use of prescribed medicationsSurgical procedures*None of the above applyOther
If any of the above apply, please provide details below
Do you have any physical, psychological, emotional, spiritual, or cultural considerations that may be relevant to our session?*
Do you have any history of sexual abuse of trauma?*
*Please note that pregnancy massage is not recommended in the first trimester for complicated pregnancies or for women who have experienced recurrent pregnancy loss.
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Service Agreement

Terms & Conditions of service
This agreement is formed between Roxanne May McKechnie, of Earthside Birth Pty Ltd. trading as 'Seasons of Womanhood' (ACN 52 651 551 487) of 127 Days Road, Grange, Queensland, 4051 - hereafter called "Roxanne May", and the Client named above in this intake form - hereafter called "The Client". The client wishes to retain the bodywork services of Roxanne May on the terms and conditions set forth in this agreement. The Client provides their full name in writing below to indicate that they have read and agree to the following terms:

The Client understands that the Pelvic Care received will be provided for the purpose of releasing stored tension and creating relaxation within the pelvic cavity. If The Client experiences any pain or discomfort during this session, they agree to immediately inform Roxanne May so that the treatment pressure may be adjusted to a level of comfort suitable for The Client.

The Client further understands that Pelvic Care should not be construed as a substitute for medical examination, diagnosis, or treatment and The Client agrees to see a physician, pelvic floor physiotherapist, or other qualified medical specialist for any mental or physical ailment of which they are aware of.

The Client understands that Roxanne May will not diagnose, prescribe, or treat any physical or mental illness, and that nothing said in the course of the session given should be construed as such.

Because Pelvic Care should not be performed under certain medical conditions, The Client affirms that they have stated all known medical conditions and answered all questions honestly.

The Client agrees to keep Roxanne May updated as to any changes in their medical profile and understand that there shall be no liability on the part of Roxanne May should they fail to do so.
This agreement is formed between Roxanne May McKechnie, of Earthside Birth Pty Ltd. trading as 'Seasons of Womanhood' (ACN 52 651 551 487) of 127 Days Road, Grange, Queensland, 4051 - hereafter called "Roxanne May", and the Client named above in this intake form - hereafter called "The Client". The client wishes to retain the bodywork services of Roxanne May on the terms and conditions set forth in this agreement. The Client provides their full name in writing below to indicate that they have read and agree to the following terms:

The Client understands that the Womb Care received will be provided for the purpose of connection to the abdomen/womb space/pelvis, releasing stored tension, and improvement of blood circulation and energetic flow to the whole abdominal space. If The Client experiences any pain or discomfort during this session, they agree to immediately inform Roxanne May so that the treatment, pressure and/or strokes may be adjusted to a level of comfort suitable for The Client.

The Client further understands that Womb Care should not be construed as a substitute for medical examination, diagnosis, or treatment, and that The Client agrees to see a physician, physiotherapist, or other qualified medical specialist for any mental or physical ailment of which they are aware of.

The Client understands that Roxanne May will not diagnose, prescribe, or treat any physical or mental illness, and that nothing said in the course of the session given should be construed as such.

Because Womb Care should not be performed under certain medical conditions, The Client affirms that they have stated all known medical conditions and answered all questions honestly.

The Client agrees to keep Roxanne May updated as to any changes in their medical profile and understand that there shall be no liability on the part of Roxanne May should they fail to do so.
This agreement is formed between Roxanne May McKechnie, of Earthside Birth Pty Ltd. trading as 'Seasons of Womanhood' (ACN 52 651 551 487) of 127 Days Road, Grange, Queensland, 4051 - hereafter called "Roxanne May", and the Client named above in this intake form - hereafter called "The Client". The client wishes to retain the bodywork services of Roxanne May on the terms and conditions set forth in this agreement. The Client provides their full name in writing below to indicate that they have read and agree to the following terms:

The Client understands that the Lymphatic Detox Massage received will be provided for the basic purpose of lymphatic drainage, movement and flow of tissue. If The Client experiences any pain or discomfort during this session, they agree to immediately inform Roxanne May so that the treatment, pressure and/or strokes may be adjusted to a level of comfort suitable for The Client.

The Client further understands that Lymphatic Detox Massage should not be construed as a substitute for medical examination, diagnosis, or treatment and that The Client agrees to see a physician, physiotherapist, or other qualified medical specialist for any mental or physical ailment of which they are aware of.

The Client understands that Roxanne May is not qualified to perform spinal or skeletal adjustments, diagnose, prescribe, or treat any physical or mental illness, and that nothing said in the course of the session given should be construed as such.

Because Lymphatic Detox Massage should not be performed under certain medical conditions, The Client affirms that they have stated all known medical conditions and answered all questions honestly.

The Client agrees to keep Roxanne May updated as to any changes in their medical profile and understand that there shall be no liability on the part of Roxanne May should they fail to do so.
This agreement is formed between Roxanne May McKechnie, of Earthside Birth Pty Ltd. trading as 'Seasons of Womanhood' (ACN 52 651 551 487) of 127 Days Road, Grange, Queensland, 4051 - hereafter called "Roxanne May", and the Client named above in this intake form - hereafter called "The Client". The client wishes to retain the bodywork services of Roxanne May on the terms and conditions set forth in this agreement. The Client provides their full name in writing below to indicate that they have read and agree to the following terms:

The Client understands that the Abdominal Scar Release received will be provided for the purposes of improved muscle function and diaphragmatic function, freedom of movement within the scar and abdomen, release of adhesions and associated pain, and reconnection to the body and breath. If The Client experiences any pain or discomfort during this session, they agree to immediately inform Roxanne May so that the treatment, pressure and/or strokes may be adjusted to a level of comfort suitable for The Client.

The Client further understands that Abdominal Scar Release should not be construed as a substitute for medical examination, diagnosis, or treatment and that The Client agrees to see a physician, physiotherapist, or other qualified medical specialist for any mental or physical ailment of which they are aware of.

The Client understands that Roxanne May will not diagnose, prescribe, or treat any physical or mental illness, and that nothing said in the course of the session given should be construed as such.

Because Abdominal Scar Release should not be performed under certain medical conditions, The Client affirms that they have stated all known medical conditions and answered all questions honestly.

The Client agrees to keep Roxanne May updated as to any changes in their medical profile and understand that there shall be no liability on the part of Roxanne May should they fail to do so.
This agreement is formed between Roxanne May McKechnie, of Earthside Birth Pty Ltd. trading as 'Seasons of Womanhood' (ACN 52 651 551 487) of 127 Days Road, Grange, Queensland, 4051 - hereafter called "Roxanne May", and the Client named above in this intake form - hereafter called "The Client". The client wishes to retain the bodywork services of Roxanne May on the terms and conditions set forth in this agreement. The Client provides their full name in writing below to indicate that they have read and agree to the following terms:

The Client understands that the Pregnancy Massage received will be provided for the basic purpose of relaxation, movement and flow of tissue. If The Client experiences any pain or discomfort during this session, they agree to immediately inform Roxanne May so that the treatment, pressure and/or strokes may be adjusted to a level of comfort suitable for The Client.

The Client further understands that Pregnancy Massage should not be construed as a substitute for medical examination, diagnosis, or treatment and that The Client agrees to see a medical professional should they require an support for any mental or physical ailment of which they are aware of.

The Client understands that Roxanne May will not diagnose, prescribe, or treat any physical or mental illness, and that nothing said in the course of the session given should be construed as such.

Because Pregnancy Massage should not be performed under certain medical conditions, The Client affirms that they have stated all known medical conditions and answered all questions honestly.

The Client agrees to keep Roxanne May updated as to any changes in their current pregnancy and understand that there shall be no liability on the part of Roxanne May should they fail to do so.
Please note that for in-home bodywork sessions, Roxanne May has an included travel radius of 20km from Grange, Queensland, 4051. For clients who live outside of this catchment, additional travel fees will apply – according to your location.
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Fees & Cancellation Policy

Fee schedule, rescheduling and cancellations
The Client acknowledges the following fee schedule (as at November 2024):
- Pelvic Care Ceremony:
  - 2 hour session incurs an energetic exchange of $222 @ The Womb Room Grange & $250 @ The Nest Mooloolah Valley
- Womb Care Ceremonies:
  - 2 hour session incurs an energetic exchange of $222 @ The Womb Room Grange & $250 @ The Nest Mooloolah Valley
  - 3 hour session (Womb Alchemy) incurs an a energetic exchange of $333 @ The Womb Room Grange & $350 @ The Nest Mooloolah Valley
- Lymphatic Drainage Massage:
  - 2 hour initial session incurs an energetic exchange of $222 @ The Womb Room Grange & $250 @ The Nest Mooloolah Valley
  - 1.5 hour follow up session incurs an energetic exchange of $166 @ The Womb Room Grange & $185 @ The Nest Mooloolah Valley
- Abdominal Scar Release:
  - 2 hour initial session incurs an energetic exchange of $222 @ The Womb Room Grange & $250 @ The Nest Mooloolah Valley
  - 1.5 hour follow up session incurs an energetic exchange of $166 @ The Womb Room Grange & $185 @ The Nest Mooloolah Valley
- Pregnancy Massage:
  - 2 hour initial or follow up session incurs an energetic exchange of $222 @ The Womb Room Grange & $250 @ The Nest Mooloolah Valley
  - 1.5 hour follow up session incurs an energetic exchange of $166 @ The Womb Room Grange & $185 @ The Nest Mooloolah Valley
The Client acknowledges that any cancellations made within 48 hours of the appointment time will be charged 50% of their appointment fees. The Client also acknowledges that any 'no show' or late cancellations (within 24 hours) will also require a credit card to be placed on file before any further appointments will be booked.

By providing their name below, The Client acknowledges that they have read, understand and agree to the above terms and conditions of service and cancellation policy as provided by Roxanne May.
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How did you find out about 'Seasons of Womanhood' services?*

Google SearchInstagramFacebookReferral from a friend/family memberReferral from another bodyworkerReferral from a healthcare providerOther
If you were referred to my services, please share their name below:
So that I may thank them :)
Clients Printed Name*

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Date*

DayMonthYear
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Bodywork Services

Contact Information

Pelvic Care

Womb Care

Lymphatic Detox Massage

Abdominal Scar Release

Pregnancy Massage

Service Agreement

Fees & Cancellation Policy