The Massage and ME
Consultation Form

Thank you so much for booking in for your Massage and ME Treatment experience,
I’m so excited to see you soon!

Please complete the following consultation form below so that I can design a treatment that is going to give you exactly what you need:

Please note: If you are a new client to Massage and Me, you will also need to fill in a pre-treatment consultation form here so that your medical conditions and contact details are recorded and reviewed before your first treatment.

We spend so much of our lives making decisions.
Sometimes the most healing thing we can do is let someone else take care of us…

Personal Information

First Name

Last Name

Phone

(###)

###

####

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

The Massage and ME
Consultation Form

Thank you so much for booking in for your Massage and ME Treatment experience,
I’m so excited to see you soon!

Please complete the following consultation form below so that I can design a treatment that is going to give you exactly what you need:

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!

Once you have submitted this form I will be in touch and will send you your guided meditation the day of your appointment.

Take care and see you soon,
Jo

Who's Jo? Learn more here

The Massage and MEConsultation Form

Thank you so much for booking in for your Massage and ME Treatment experience, I’m so excited to see you soon!

Please complete the following consultation form below so that I can design a treatment that is going to give you exactly what you need:

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!

Once you have submitted this form I will be in touch and will send you your guided meditation the day of your appointment.

Take care and see you soon, Jo

The Massage and ME
Consultation Form

Thank you so much for booking in for your Massage and ME Treatment experience,
I’m so excited to see you soon!

Take care and see you soon,
Jo