Services
Sports & Deep Tissue
Myofascial Release
Remedial Massage
Trigger Point
Pregnancy Massage
Dry Needling
Corporate Massage
Mobile Massage
About Us
About the Clinics
Therapists
Rebates
Cancellation Policy
FAQs
COVID-19 Declaration
Locations
Sydney
Norwest
Inner West
Book Now
Services
Sports & Deep Tissue
Myofascial Release
Remedial Massage
Trigger Point
Pregnancy Massage
Dry Needling
Corporate Massage
Mobile Massage
About Us
About the Clinics
Therapists
Rebates
Cancellation Policy
FAQs
COVID-19 Declaration
Locations
Sydney
Norwest
Inner West
Book Now
Save time - fill out your Remedial Massage information prior
Name
*
First Name
Last Name
Date of Birth
*
Gender
*
Male
Female
Address (Street, Suburb)
*
Mobile Number
*
Email
*
Reason for Visit
*
Relaxation (Light - Medium)
Remedial (Medium - Firm)
Deep Tissue / Sports (Firm)
Area of Pain & Discomfort
What makes the area worse or better?
Please indicate if you have or have recently had :
Fatigue
*
Yes
No
Epilepsy
*
Yes
No
Dizziness / Vertigo
*
Yes
No
Low/High Blood Pressure
*
Yes
No
Depression
*
Yes
No
Anxiety
*
Yes
No
Leg Cramps
*
Yes
No
Neck / Back Pain
*
Yes
No
Headaches / Migraines
*
Yes
No
Hepatitis / HIV
*
Yes
No
Thyroid Disorders
*
Yes
No
Skin Disorders
*
Yes
No
Joint Replacements
*
Yes
No
Liver / Kidney Problems
*
Yes
No
Are you currently taking Medication?
*
Yes
No
List your Medication
List any other concerns you may have
Policies on privacy & fees
1. I understand that appointments cancelled at BetterU Remedial Massage in Sydney within 16 hours may incur a 50% charge. A cancellation within 4 hours will incur a full fee charge if another client is not able to take the consultation. 2. I have disclosed all medical history accurately to BetterU Remedial Massage in Sydney. 3. All information posted will be kept confidential and will not be sold or given to any third parties.
Thank you! Your information has been sent to your therapist. Enjoy your session!
