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Get the free Shiatsu Therapy Intake Form - Natura Wellness Clinic

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3885 Duke of York Blvd., Suite C211, Mississauga, ON L5B0E4 T: (905)2766800 F: (905)2766802 www.NaturaWellnessClinic.com DATE OF FIRST VISIT: SHIATSU NEW PATIENT INFORMATION FORM NAME: D.O.B. (DUMMY):
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How to fill out shiatsu therapy intake form

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How to fill out a shiatsu therapy intake form:

01
Start by filling out personal information such as your name, address, and contact details.
02
Provide information about your medical history, including any pre-existing conditions, past injuries, or surgeries. This will help the therapist understand your health background and tailor the session accordingly.
03
Indicate any medications you are currently taking, including the dosage and frequency. This is important as certain medications may affect the therapy or require adjustments.
04
Mention any allergies or sensitivities you have, especially if it pertains to oils, lotions, or other products used during the session.
05
Be sure to disclose any current symptoms or complaints you have, such as muscle pain, stress, or sleep issues. This will help the therapist address your specific concerns during the session.
06
If you have any specific preferences or goals for the treatment, such as focusing on a particular area or achieving relaxation, communicate these clearly on the form.
07
Sign and date the form to acknowledge that the information provided is accurate and complete.
08
Keep a copy of the intake form for yourself, and provide it to the shiatsu therapist on your first visit.

Who needs a shiatsu therapy intake form?

01
Individuals seeking shiatsu therapy for various physical or mental health concerns may be required to fill out an intake form. This can include people experiencing chronic pain, stress, fatigue, or those seeking relaxation and well-being.
02
Clients with specific health conditions or a history of injuries can benefit from a shiatsu therapy intake form. This allows the therapist to assess any contraindications and tailor the treatment accordingly, ensuring safety and effectiveness.
03
Individuals who are new to shiatsu therapy or seeking treatment from a particular therapist may be asked to complete an intake form as part of the initial assessment process. This helps establish a baseline understanding of the client's health and goals for the therapy.
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The shiatsu therapy intake form is a document that collects relevant information about a client's health history, current symptoms, and goals for treatment.
Clients who are seeking shiatsu therapy treatments are required to fill out the shiatsu therapy intake form.
Clients can fill out the shiatsu therapy intake form by providing accurate and detailed information about their health history, current symptoms, and treatment goals.
The purpose of the shiatsu therapy intake form is to help the therapist understand the client's needs, preferences, and health concerns in order to provide safe and effective treatment.
The shiatsu therapy intake form typically includes questions about the client's medical history, current health conditions, medications, allergies, and goals for treatment.
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