From Exhausted to Energised
Consultation Form

Welcome to the Massage and Me Package ‘From Exhausted to Energised’
I’m so excited to see you soon!

Please complete the following consultation form with me below so that I can tailor your treatments to your needs as much as possible:

Renewed Energy Awaits…

Personal Information

First Name

Last Name

Medical Conditions: Do you have any particular health concerns at the moment?

Yes

If YES - please explain further

How would you describe your stress levels?

How are your energy levels? When do you find your biggest dip in energy in the average day?

Roughly how many hours of sleep do you usually get per night?

Where are your main areas of tension at the moment?

What was the main reason for you booking this package?

Can you think of a few words to describe how you'd like to feel at the end of your last treatment?

Declaration and Consent

Please confirm you agree with the following statement: The information I have provided is correct. I have not withheld any personal or medical information that may affect my treatment. I will adhere to the Massage and Me safety and hygiene guidelines before and during my treatment. This form will be kept on file securely by Jo at Massage and Me, and will not be shared with any third parties.

I agree

I do not wish to continue

For my neurodivergent Clients:

Please follow the link below for my webpage entitled ‘What to expect from your Massage and Me Treatment’ that may help you before you arrive. Please ask me at any point, whether pre-appointment or during your treatment, any questions you may have, or for me to alter something that might help you to enjoy your treatment more. My job is to make you comfortable.

WHAT TO EXPECT FROM YOUR MASSAGE AND ME TREATMENT

Thank you so much. Please don’t hesitate to contact me if you have any questions or concerns.

Now for the excitement of looking forward to your appointments!

To start you off on this relaxing, empowering journey, I have recorded an extra guided meditation below. I hope it helps to keep you grounded and to bring you some peace until your first treatment here at Massage and Me.

From Exhausted to Energised
Consultation Form

Welcome to the Massage and Me Package ‘From Exhausted to Energised’
I’m so excited to see you soon!

Please complete the following consultation form with me below so that I can tailor your treatments to your needs as much as possible:

Renewed Energy Awaits…

For my neurodivergent Clients:

Thank you so much. Please don’t hesitate to contact me if you have any questions or concerns.

Now for the excitement of looking forward to your appointments!

To start you off on this relaxing, empowering journey, I have recorded an extra guided meditation below. I hope it helps to keep you grounded and to bring you some peace until your first treatment here at Massage and Me.

Take care and see you soon,
Jo

Who's Jo? Learn more here

From Exhausted to EnergisedConsultation Form

Welcome to the Massage and Me Package ‘From Exhausted to Energised’ I’m so excited to see you soon!

Please complete the following consultation form with me below so that I can tailor your treatments to your needs as much as possible:

Renewed Energy Awaits…

For my neurodivergent Clients:

Thank you so much. Please don’t hesitate to contact me if you have any questions or concerns.

Now for the excitement of looking forward to your appointments!

To start you off on this relaxing, empowering journey, I have recorded an extra guided meditation below. I hope it helps to keep you grounded and to bring you some peace until your first treatment here at Massage and Me.

Take care and see you soon, Jo

From Exhausted to Energised
Consultation Form

Welcome to the Massage and Me Package ‘From Exhausted to Energised’
I’m so excited to see you soon!

Take care and see you soon,
Jo