appointment consultation form
By submitting this form I confirm that the information provided is true and I have not withheld any information concerning my health. I undersstand there is a possibility I may experience some minor reactions as my body adjusts to the treatment.
I understand that this treatment is not a substitute for medical diagnosis or treatment and the therapist does not diagnose illness, disease or any other condition. While I recognise that all due care will be taken by the therapist, I am aware that my participation in the treatment is voluntary and I give my consent to having the massage therapy treatment. I confirm that my records can be retained in line with legal requirements..