Health Screening - Poise Sport & Remedial Massage

This health screening form is to check that you are feeling well before your massage appointment.

Please complete and submit this form no later than 24 hours before your appointment. Please don’t hesitate to contact me if you have any questions or problems on 07985 265905 or email me at gail(Replace this parenthesis with the @ sign)poiseremedialmassage.com

Name *

First

Last

Date of Appointment *

Date

Time

Are you experiencing any symptoms of the common cold, flu or Covid-19 ? *

If the answer is yes, we will need to have a chat to see if it would be better to re-arrange your massage appointment.

Have you had the COVID vaccine in the last 48 hours? *

People react differently to the COVID vaccine. For this reason, no treatment can be undertaken within 48 hours of receiving the vaccine

Have you been diagnosed with Post-COVID 19 (Long COVID)? *

If you have been diagnosed with long Covid, we will discuss how to adapt your massage to assist you in your recovery.

Consent declaration *

The information I have given in this form is honest, accurate and correct to the best of my knowledge. I have had the opportunity to ask all the questions about its consent and all of my questions have been answered to my satisfaction. I appreciate that although all reasonable steps to reduce risk of infections have been taken, including screening potential COVID-19 cases and undertaking increased hygiene and distancing protocols there may still be a risk of infection from face-to-face treatment. I knowingly and willingly consent for face-to-face appointments to take place.

Poise Sport & Remedial Massage

5.0

Based on 4 reviews

review us on

Jane Hebblethwaite

17:12 17 Feb 19

I have been under Gail's expertise for remedial and sports massage for nearly 18 months and would highly recommend her to anyone. She has helped me recover from a very debilitating sciatica episode whilst also managing my neck, shoulder and foot niggles and mobility, with her fantastic massage coupled with excellent after care with her focused and planned exercise therapy sheets. She offers a very calm and friendly atmosphere and wonderful smelling therapy oils. A must for anyone, problems or not.

Beryl Miles

11:17 16 Feb 19

Gail is a brilliant practitioner. You cannot fail to benefit from her treatment. She is a true professional and can pinpoint where your problems are and treat them successfully.

Anne Croft

09:45 14 Feb 19

Always feel much better after a massage.
She finds any problems and soothes them away

Nicole Bourke

09:18 14 Feb 19

I go in feeling like a creaking old person and come out an hour later feeling ten years younger. I’ve always been hesitant about having a sports massage as I don’t do any sport and therefore assumed it was for muscular sporty types. It has helped me though. Thank you.

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