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  • About You

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  • Covid Screening

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  • If you are unvaccinated then you hereby agree to wear a mask throughout the treatment in order to prevent transmission, as far as is possible.  Extra cleaning and sanitisation procedures for therapist and equipment will also be necessary and so there will be a £5 charge added to the cost of treatment to cover this.

  • Medical Details

  • If you are pregnant, please fill out the section below:

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  • I confirm that I have provided true and accurate information to the best of my knowledge. I accept that Essential Massage and Soft Tissue Therapy ('Essential') will use the information here only as a baseline for treatment and that any omission which affects my treatment is not the fault of Essential.

    Essential undertakes to keep all information provided here confidential in line with the requirements of GDPR (2018). Essential further undertakes to only release this information to other practitioners with your express written permission.  Please be aware that the law currently requires that medical records are kept for 7 years post-treatment for adults and until the age of 21 for anyone treated before they turned 18.  All records will be securely destroyed after the relevant time period has elapsed.

    Essential will not contact you without permission, as detailed below. Ticking the box confirms that you agree to these Terms and Conditions and are happy to proceed with treatment on this basis.

  • Thank you for your time in completing this form - I look forward to meeting you soon!

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