• HCCH First Visit Registration Form

    Mind • Body • Wellbeing • Coaching • Massage • Sports Massage • Indian Head Massage

  • Client Details

    A short first-step form to help us understand what you need and identify anything important before your first appointment.
  • Date of birth
     - -

  • Your Appoinment

    What type of appointment are you interested in?
  • Appointment type

  • Before Your Appointment

  • Important note

    This short form helps HCCH understand what has brought you here and identify anything important before your first appointment. Depending on your appointment type, you may be asked to complete a further online consultation before you attend.
    For massage or bodywork, this may simply include a few key health questions and a body map. For longer combined sessions, or wellbeing/mindset-focused appointments, we may ask you to share more about what you are experiencing, what you would like support with, and anything relevant to your health or wellbeing. This helps your session feel more personal, prepared and appropriate for you.

  • Contact & Client Records

  • I understand that HCCH may contact me by phone, text or email about my enquiry, booking and appointment arrangements.
    I understand that my client information may be stored securely in electronic format to help provide safe and appropriate care.

  • Consent

  • Confirmation

  • Thank you for taking the time to complete this form.
    Declaration:

  • Should be Empty: