• RHE Studio

    Client Information & Health intake Form

  • CLIENT INFORMATION

    Please complete this form before your appointment. The information provided helps your RMT determine whether lymphatic therapy and any selected enhancements are appropriate and allows your treatment to be customized to your needs.
  • Format: (000) 000-0000.
  • Date of Birth*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Format: (000) 000-0000.

  • Consent
    I confirm that the information provided in this form is accurate and complete to the best of my knowledge.

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  • TREATMENT SELECTION

  • Which Brazillian Lymphatic Massage service(s) are you interested in?*
  • Treatment Goals: What would you like to focus on?*

  • OPTIONAL TREATMENT ENHANCEMENTS

    Enhancements are optional and may be modified or declined based on your health history and treatment assessment.

  • WOOD THERAPY ENHANCEMENT

    Specialized wooden tools are incorporated into the treatment to complement manual techniques and provide a more stimulating sculpting experience.

    Potential benefits:

    • Supports circulation
    • Complements lymphatic techniques
    • Promotes tissue mobility
    • May help reduce feelings of heaviness or fluid retention
    • Enhances the sculpting experience

    May not be appropriate with:

    • Active infection or open wounds
    • Unexplained swelling
    • Suspected or diagnosed blood clot/DVT
    • Recent surgery without appropriate clearance
    • Significant bruising or bleeding concerns
    • Significant pain or skin sensitivity
  • Would you like to add Wood Therapy?*

  • INFRARED SAUNA BAG

    A relaxing infrared heat experience designed to provide gentle warmth before or after lymphatic therapy.

    Potential benefits:

    • Promotes relaxation
      Warms muscles and soft tissues
      Supports circulation
      May help ease feelings of stiffness and tension
      Enhances the overall wellness experience

    May not be appropriate with:

    • Fever or acute illness
    • Dehydration
    • Heat intolerance
    • Certain cardiovascular conditions
    • Certain blood pressure conditions
    • Pregnancy unless cleared by your healthcare provider
    • Conditions or medications that affect temperature regulation

    Please inform your RMT about cardiovascular conditions, medications, pregnancy, or heat sensitivity before treatment.

  • Would you like to add Infrared Sauna Bag?*

  • Enhancement Consent
       
       
       
    *      
             
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  • UNDERSTANDING BRAZILIAN LYMPHATIC DRAINAGE

    Brazilian Lymphatic Drainage is a specialized bodywork technique that combines gentle lymphatic drainage with more dynamic, sculpting-focused movements. The treatment follows appropriate lymphatic pathways while incorporating rhythmic techniques designed to encourage natural fluid movement and circulation.

    Your treatment may include light, rhythmic lymphatic strokes, directional movements, gentle pumping techniques, and targeted sculpting techniques to address areas such as the abdomen, waist, hips, glutes, and legs.

    Potential Benefits

    Brazilian Lymphatic Drainage may help:

    • Support healthy lymphatic circulation
    • Encourage natural fluid movement
    • Reduce the appearance or feeling of temporary puffiness and fluid retention
    • Ease feelings of heaviness, bloating, or congestion
    • Support circulation and tissue fluid movement
    • Promote a lighter, less congested feeling
    • Enhance the appearance of body contours temporarily
    • Support relaxation and overall wellness
    • Promote a refreshed feeling following treatment
    • Complement post-workout recovery and general wellness


    WHAT TO EXPECT

    Brazilian Lymphatic Drainage is not a weight-loss treatment and does not remove body fat. Any changes in appearance or measurements are generally related to fluid movement, reduced puffiness, and temporary changes in tissue congestion.

    • Results vary between individuals and may be influenced by hydration, lifestyle, activity level, hormonal changes, and overall health.


       

  • Results vary between individuals. Lymphatic therapy does not guarantee a specific cosmetic or therapeutic outcome and is not intended to diagnose, treat, or cure a medical condition. 

  • What to expect:

    Assess & Personalize
    Your appointment begins with a health review and brief consultation to understand your goals and determine an appropriate treatment approach.
    Activate
    Gentle, rhythmic techniques are used to encourage lymphatic movement and support circulation.
    Restore
    Your selected facial, abdominal, or full-body treatment is performed using techniques appropriate for your needs.
    Integrate
    Your RMT will provide individualized aftercare recommendations and answer any questions following your treatment.   

  • Contraindication & Health Changes
    I agree to inform RHE Studio before each appointment if I:

    • Become pregnant
    • Start using Accutane or prescription retinoids
    • Experience active acne outbreaks, cold sores, infections, open wounds, or skin irritation
    • Receive recent cosmetic treatments or injections
    • Experience changes in medications or medical conditions
  • Client Acknowledgement*

  • HEALTH HISTORY

  • Do you currently have or have you recently experienced any of the following?*
  • Are you pregnant or in postpartrum*
  • Do you have lymphedema or diagnosed lymphatic disorder?*
  • Are you currently taking any medications or supplements?*
  • Do you have any allergies or sensitivities?*
  • Have you had any surgery, cosmetic procedure, injection, or medical procedure the last 6 months?*

  • Medical Clearance

    If you have a medical condition, recent surgery, active cancer treatment, cardiovascular concerns, blood-clotting concerns, or another condition that may affect your safety, your RMT may request medical clearance before treatment.

     

    Important
    Please notify your RMT if your health status changes between completing this form and your appointment.

  • Do you have medical clearance/recommendation for massage or lymphatic therapy if required?*
  • Date*
     - -
    2 digit month, 2 digit day, 4 digit year

  •  

    PREPARATION FOR YOUR TREATMENT

    Before Your Treatment
    To help you feel comfortable during your appointment:

    • Stay adequately hydrated according to your normal needs.
    • Avoid arriving immediately after a very large meal.
    • Wear comfortable clothing.
    • Inform your RMT of any new medications, procedures, injuries, or health changes.
    • Provide any relevant medical clearance or healthcare recommendations when applicable.
    • Allow yourself enough time to arrive relaxed and complete your intake.

     

    During Your Treatment
    Your appointment will begin with a brief consultation and health screening.

    Your RMT will discuss your goals, determine the appropriate treatment approach, and explain what will be performed.

    You will be appropriately draped throughout the treatment. Only areas necessary for treatment will be exposed.

    MLD generally uses light, rhythmic pressure and should not be painful.

    Please communicate immediately if you experience:

    • Unusual pain
    • Dizziness
    • Nausea
    • Shortness of breath
    • Feeling faint
    • Excessive discomfort
    • Anything that does not feel right

    Your treatment can be modified or stopped at any time.

    After Your Treatment
    Following lymphatic therapy, you may wish to:

    • Drink water according to your normal hydration needs.
    • Allow yourself time to relax following your appointment.
    • Engage in gentle movement, such as walking, if comfortable.
    • Follow your RMT's individualized recommendations.
    • Pay attention to how your body feels following treatment.

    Individual responses vary. Some clients may feel relaxed, refreshed, or temporarily tired following treatment.

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  • Date:*
     - -
    2 digit month, 2 digit day, 4 digit year
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