Client Consultation Form

    Emergency Contact

    Medical Information

    Do you have any current or previous injuries that may affect your treatment?

    Do you have any allergies we should be aware of?

    Do you have any medical conditions that may affect your treatment?

    Are you currently taking any medication that may affect your treatment?

    Have you had any surgery, fracture, or hospital treatment in the last 12 months?

    How did you hear about David Sears Sports Massage?

    Consent & Marketing