• SCAR MODEL AGREEMENT

    SHARON WHEELER'S SCARWORK COURSE

  • Section 1:

    Please read this carefully

  • 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, learning this specialist modality. 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 in doubt, please send us a photograph before applying.  

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

    e. There is not pain. Mild tenderness is acceptable; the students cannot work where there is severe pain.

    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 appropriately on the questionnaire below and you will need to supply a letter, well in advance of the course, from the surgeon / oncologist to jan@bodyinharmony.org.uk giving permission for us to work with you.

    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. Put as many options as possible as we need to juggle everyone in and the more flexible you can be, the more likely we are to be able to accommodate you.

    We will email you back to confirm the booking at our end. You will then have just one more link to click on to confirm you will be there.  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 and park: 


    Miller's Way Project
    Miller's Way, Shepherds Bush, London, W6 7NH

    When you arrive please ring the bell. The buzzer will go when the door can be opened. Or one of our team will come and meet you. When you enter please keep your voice down and change out of your outdoor to your indoor shoes/socks/bare feet. Thank you.

    Directions, public transport and parking

  • 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 indicate your availability for all sessions and days. 

    The teacher demo model places are highly sought after, however we choose people who, ideally, have had no work done to their scar and have scars clearly visible to the students as they gather around the couch, i.e. large and obvious. Please do not just request these places as they go quickly - always add in the Clinical Practice sessions with the students that you can attend, as they are also valuable and carefully supervised by the Teacher and Assistant Teacher; otherwise you may end up without any place at all and miss out on the opportunity.

    If you apply for the 3rd demonstration model place on day 4, you may then stay on to receive work from the students in the Clinical Practice session, so make it clear if you are available.

    Make your selection below.

  • Demonstration models for teacher - each option has different requirements - please read carefully. Please note we need you to arrive 15 minutes earlier than the start time:*
  • Clinical Practice Sessions with supervised students (we welcome all type/ages of scars subject to the criteria for treatment given on page 1**). Please note we need you to arrive 15 minutes earlier than the start time:*

  • Section 2:

    Please complete all * fields to submit this form

  • 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.

  • 0/250
  • 0/250
  • Have any of these scars received treatment previously?*
  • 0/250
  • Do you have mesh in your scar*
  • 0/250
  • Working on a pelvic scar/s may involve working around the pubic area, with your permission and keeping you covered except for the area being worked on. As much privacy as possible within the classroom situation will be accorded you (we keep you covered as much as we can during the session, and put you on a therapy couch away from models of the opposite sex). Do you consent to this?
  • Please note that you may be worked on by both male and female students. If you are happy to be treated by either, please tick No Preference. I agree to be treated by:
  • 0/250

  • Important Please Note:

    If you have had cancer, please see Criteria for Treatment at the top of this form. Then, if appropriate, please 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, well in advance, to info@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:'

  • I confirm that I was discharged by the surgeon / oncologist five years or more ago, and have no active cancer in the body to the best of my / their knowledge:

  • Section 3:

    Please read carefully and confirm your agreement with your signature below

  • 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 teachers 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.

    *Hygiene: please remember to bring your clean socks/dedicated indoor shoes.

    *You will need to bring your own linen which comprises: two sheets/light blankets/towels to cover the therapy couch and yourself, plus a small headrest and knee rest with you if possible, all rolled up together so they can easily be rolled out onto your sterilised therapy couch. (Please let us know if you cannot bring these to your session). 

    Many thanks

    Jan Trewartha

    Principal

    www.bodyinharmony.org.uk

    jan@bodyharmonytraining.org.uk

  • I confirm that I meet the criteria as laid out in this agreement.*
  • Date completed*
     / /
    2 digit month, 2 digit day, 4 digit year
  • Should be Empty: