Is this ok for a consultation form?

[happy_girl]

please can i be cheeky but please can you tell me if this is ok for a consulation form,​

​

body massage treatment consultation form​

Client;
Date of birth;
Date of treatment;
Male or female;


What is the treatment for;
Tick
Massage medium
Tick
Relaxation

Oil

Maintenance of physical health

Cream

Sense of wellbeing

Talc

Uplifting

Gel

Anti-cellulite/ stimulation

Emulsion

Full body/ half

Powder



Lifestyle

Occupation;

Exercise habits;
Family situation;

Smoking habits;
Dietary and fluid intake;

Sleep pattern;
Hobbies, interests and how to relax;




Contra- indications
Tick
Areas & massage techniques
Tick
Severe circulatory disease

Face, neck & head

Thrombosis/embolism

Chest & shoulders

Epilepsy

Abdomen

Diabetes

Back

Skin disorders

Legs & feet

Severe bruising

Arms & hands

Recent haemorrhage/swelling

Petrissage

Cuts or abrasions

Effleurage

Recent operations

Tapotement

Recent fractures or sprains

Vibration

Pregnancy

Friction

Menstruation



Asthma



Medication





Contra-actions

Erythema;
Why the treatment can’t be carried out;
Skin reactions;
Modification of treatment;


Aftercare
Tick
Description of advice given
Avoid activities which can cause contra-actions


Future treatment needs


Modifications of lifestyle patterns


Healthy eating and exercise


Suitable homecare products and their use




I ……………………………………………………… agree that all information given to ******* was correct to my knowledge.
Signed……………………………………………… Date……………………………………………..

 

[happy_girl]

it is not that messy as it is in boxes etc but i have copy and pasted it and it has come up like this :evil:

 

[skala]

Yes I think this is good and you cover every thing, but what about maybe having sections eg lifestyle,alcohol smoking etc all in one. Just to shorten it abit?xx

 

[happy_girl]

Yes I think this is good and you cover every thing, but what about maybe having sections eg lifestyle,alcohol smoking etc all in one. Just to shorten it abit?xx

thank u for looking at it even though its all mixed up, it is all in one section just for some reason when i did the copy it has mixed it all up

 

[skala]

ok, it does that to me when I copy and paste. Well done though )

 

[happy_girl]

thank u its a pain isn't