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Client Health Information and Consent Form

Please complete the form before your first appointment

Full Name

Email

What is your occupation?

Phone number

Date of Birth

What is your address?

Emergency contact

Do you have an allergies or have sensitive skin?

Are there an area/s were you are tender or generally hold tension or discomfort?

Do you have any past/present injuries of relevance?

Any other health issues?

How did you hear about us?

I consent that Flow Massage is not responsible for any physical injuries. Or provide any medical diagnosis or prescribe medical treatment.

Thanks for submitting!

Created by Nati Rossi (Website Designer) in collaboration with Bespoked Digital (Website Developer)

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