THERAPY CONSULTATION

Contact details are not shared with third parties or used for marketing, they are used only if we need to contact you regarding an appointment or with related information.

Are you affected by any of the following?
Do you have family history of any of the following?

Please (briefly!) provide detail for any;

I have stated all my known medical conditions, in confidence, and take it upon myself to keep the therapist updated on my health. I consent to this consultation and treatment which will involve soft tissue techniques

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