SCAR MODEL AGREEMENT

Dear Volunteer, 

Thank you very much for assisting our students by volunteering as a ScarWork 'model'. You will be helping our students and we will be helping you - we look forward to working with you. 

You will be receiving work to your scars and adhesions free of charge and under supervision. The students are all professional, practising therapists. The work they do on you will be kept confidential.

Please Note:

• We will ask if we may photograph the scar(s) before and after treatment. We may also ask you if the photos and your history, or any feedback from you can be used to promote ScarWork - this can be anonymous or with your name attached, but the decision is yours.
• There is no obligation to provide photographs or testimonials. If, however, you are willing, you will be given a consent form to fill in and sign and your wishes will be adhered to. 
• You may be worked on by both male and female students. If you do not want to be treated by somone not of your gender, please indicate that when asked below.

**N.B Criteria for Treatment: Your scar can only be worked on: 

a. If you have been discharged by your surgeon

b. You are not pregnant

c. Your scar is not severely keloid; if you are unsure, please send us a photograph before applying.  

d. If there is no infection, areas where the scar is open, or weeping.

e. There is no pain. Mild tenderness is acceptable; we cannot work with people in severe pain; you should see your GP in such a case.

f. If there is no redness from previous radiation therapy.

Should you have had cancer you must have been discharged 5 years or more ago and not have active cancer. If you are unable to confirm this, please tick NO on the questionnaire below and you will need to supply a letter from the surgeon / oncologist to jan@bodyinharmony.org.uk well in advance, giving permission for us to work.

If you have mesh inserted please let us know so we can work appropriately.

 

Please see the dates and time available below within the form - fill in the list of scars and a brief history, and the session/s you can attend and would like to book in for. 

We will email you back to confirm the booking. Once you have confirmed your booking, we are relying on you to be there. If you are unable to attend because of an emergency, please ring me on 07724 027 748 giving as much notice as possible. 

Please come 15 minutes before your booked time - tea is available while you wait. 

Thank you, 

Jan 

Jan Trewartha (Accredited ScarWork Teacher) 

Venue Details - please allow plenty of time to find the venue: 

 

NLSSM, Tottenham Hale, North London
THE HUB, UNIT 3I & 3J, 25 ASHLEY ROAD
TOTTENHAM, LONDON N17 9LJ
United Kingdom
020 8885 6062
View Venue Website

N.B.  We are inviting ‘scar models’ for the following times and days.

Please select all the sessions below that you would be able to attend.

If you have severe scarring you may be able to come to two sessions, so please indicate your availability for all sessions and days. 

Please select below the session/s you would be available to attend.

Please note we are only able to work on the scars that you tell us about on this form so please tell us about all the scars you would like worked on, whether big or small, old or new.

Important Please Note:

If you have had cancer, please see Criteria for Treatment at the top of this form. Then, if appropriate, sign below to confirm you were discharged five years or more ago and have no active cancer to the best of your/your oncologist's knowledge. If you are unable to confirm this, please tick NO and you will need to supply a letter from the surgeon / oncologist to jan@bodyinharmony.org.uk giving permission for us to work.

If you have not had cancer please skip to 'Section 3: What you are agreeing to:'

What are you agreeing to:

• I understand that the students are practising therapists and will be supervised by Jan Trewartha, teacher accredited by Sharon Wheeler (originator of the ScarWork techniques), and any trainee or assistant teacher working on the day. 
• I understand that this is a gentle, non-invasive treatment and accept my responsibiliy to give feedback as requested and that I must, at any time during the treatment, state clearly if I am experiencing pain so that the student can adapt his/her pressure/approach.
• I understand that I will be contacted within a few weeks after the session for feedback and agree to email the school back with an update on the results of the ScarWork. 
• I agree that my name & email address will be added to Body in Harmony Training's email list, to invite me to future courses - I can either attend again if I still need some work done, or recommend friends as scar models. I can easily unsubscribe from this list if I wish. 

Thank you for volunteering to help our students and to receive the benefit of their training. 

Once we have confirmed your booking, we are relying on you to be there. You will receive a confirmation by email of your booking. Please read it carefully.

 

You will need to bring your own linen which comprises: A sheet to cover the therapy couch, a large towel to cover yourself with. We have some blankets on site but cannot provide for everyone because of limited laundry facilities there, thank you for your understanding. If you cannot bring the above, please email me on jan@bodyinharmony.org.uk.

Please wear clean, warm socks or dedicated indoor shoes/slippers in the venue room, for hygiene purposes.

Many thanks

Jan Trewartha

Principal

www.bodyinharmony.org.uk

jan@bodyharmonytraining.org.uk