Thank you for booking in for a massage with me.


Please complete the below form as fully as possible prior to your appointment.

By submitting this form, you are declaring the information you provide is accurate and that you are giving your consent to receive treatment with no knowledge of any other underlying conditions that may prevent treatment from going ahead. You are also declaring that you have been full informed of and agree to the COVID-19 adaptations to procedure, including the requirement for you to wear a mask for the duration of your appointment.

All details are stored securely and will only be used to give me a relevant overview of your health and any existing medical conditions that may require any adaptations to treatment.

Contraindications To Treatment - please tick any that apply

Thank You!