CLIENT PROFILE

Thank you for completing our client profile. This profile will assist us in identifying relevant medical or lifestyle information that may affect the service you have scheduled with us today and for your future visits.

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Contagious skin conditionOpen sores or woundsVaricose veinsEasy bruisingRecent accident or injuryRecent fractureRecent surgeryArtificial jointSprains/StrainsCurrent feverSwollen glandsAllergies/SensitivityCirculatory disorderAtherosclerosisHeart conditionHigh or low blood pressurePhlebitisdeep vein thrombosis/blood clotsjoint disorder / rheumatoid arthritis/osteoarthritis/tendonitisosteoporosisepilepsyheadaches/migrainescancerdiabetesdecreased sensationback/neck problemsFibromyalgiaTMJcarpal tunnel syndrometennis elbow



Clients under the age of 17 must be accompanied by a parent or legal guardian during the entire session. Informed written consent must be provided by parent or legal guardian for any client under the age of 17.

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