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  • Client Intake Form

    Mallee Wellbeing co
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  • Medical Information

  • Presenting Condition

  • Informed consent and consent to share information

  • • I have provided a detailed medical history to the best of my ability. I do not expect the therapist to have foreseen any previous or pre-existing condition that I have not mentioned.

    • I also understand that massage therapy may produce side effects such as muscle soreness, mild bruising, increased awareness of pain and light-headedness amongst other possible temporary outcomes.

     • I am aware that the therapist does not diagnose illnesses, prescribe medication nor physically manipulate the spine or its immediate articulations.

     • The therapist understands that I have the right to question procedures used and to receive an explanation of any procedures that the therapist performs.

     • I will tell the therapist about any discomfort I may experience during the therapy session and understand that the therapy will be adjusted accordingly.

    • I understand that all records relating to my treatment will be retained in line with all Australian State and Federal Laws and that I may request a copy of these records at any time. I understand that this information may be shared with my Private Health Fund for the sole purpose of verifying any claim I may make for the service.

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