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All Things Health & Wellbeing Title

Counselling & Somatic Bodywork Therapies

Client Consultation & Consent Form - Bodywork

Before your first consultation please follow through with these 2 easy steps:

 

1/ Please read all the information below

2/ Complete the online form below & click SUBMIT

CLIENT GENERAL INFORMATION
 
The following information is designed to help you understand the therapy process. As a client you have certain rights that are important for you to understand. If you have any questions regarding anything that is explained below please do not hesitate to ask.
 

APPOINTMENTS
 
Bodywork sessions 60mins in duration unless pre-organised to be longer. When you make an appointment this time is reserved especially for you so could you please let me know, at least 24hrs in advance, if you are unable to attend so that I have time to offer your appointment to someone else.
 
Without 24hrs notice you may be charged a cancellation fee or the full fee. Fees are to be paid on the day of the consultation by cash or direct debit.
 
Please be on time for your appointment. If you are late I will need to shorten the length of your appointment so as not to inconvenience the next client. Thankyou for your understanding on this.
 
Clients attend sessions on the understanding that they take full responsibility for their session, and may withdraw consent at any time. This consent form will remain active for any future visits and other forms of consultation unless otherwise notified. If you have any concerns at any time please feel free to discuss them with your therapist at any time.

BODYWORK MODALITIES
 
I consent to receiving treatment in any of the below complementary therapy and somatic modalities.

 

- Relaxation Massage

- Remedial Massage

- Chakra-puncture (a gentle needling technique that pierces the skin to a depth of only 0.2-0.4mm using very fine needles and is not acupuncture)

- Esoteric Connective Tissue Therapy

- Esoteric Healing

- Egyptian Facial Release

- Yoga of Stillness

- Meditation

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I understand that I can decline treatment at anytime should this change.

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The therapists at this clinic are not qualified to and not do they give medical diagnosis or offer cures.

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If you currently or in the last 6 months have been clinically diagnosed with any of the below Mental Health conditions please inform your therapist as a referral may be a better option for your care...

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- Schitzophrenia

- Bipolar

- Mania | Delerium | Psychosis 

- Borderline Disorder

- Major Depressive Disorder

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CONFIDENTIALITY & PRIVACY 

 

All communications (emails, phone calls, reports etc.) become part of your clinical records, which are stored in your client file. Client files are held in a secure filing cabinet that is accessible only by your therapist. If you would like more detail on the Privacy Policy you can request a copy. The Privacy Policy contains information about how to access and seek correction of your personal information, and how to lodge a complaint about the management of your personal information.

NOTE: if after reading this document you are at all unclear about anything,

please ask prior to the commencement of your session/appointment

Expression is Powerfull & Healing

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