Treatment Consultation Form

Reflexology is a holistic therapy. Through the application of steady, even pressure using specific thumb and finger techniques, reflexology connects with the peripheral nervous system and encourages the body to relax.  Each reflex point on the Feet, Face and Hands connects with a specific organ, gland, body part, or body system. The treatment reduces stress and increases your health and wellbeing.

For insurance purposes,  I would really appreciate it if you could download the enclosed Doctor Consent Form and get it signed by your doctor to confirm that it is OK for you to have a treatment.  Bring it along with you when you come for your appointment 🙏🏽.  Doctor Consent Form


Personal Information

Medical Information

We may need to make adjustments to the plinth/chair depending on the following;
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