Client Consultation Form
Date:…………...Time:…………..…..
Guest Name:
Room No:
Male Female
Sex
Nationality:
Course of Treatments :
Concerns:
Essential Oil Uses:
Skin Type:
Carrier Oil Use:
Have you ever had a massage before?
If Yes, what kind of massage?
What strength of massage pressure would you prefer?
Hard
Moderate
Soft
Comment
Contraindication
High/Low blood pressure
Pregnancy
Diabetes
Heart Attack
Epilepsy
Asthma
Varicose Veins
Metal Plates / Pins / Electronic Implants
Recent operation, fractures or sprain
Wounds, cuts or abrasions
Consultant’s Signature
Client’s Signature