Help with drafting one-minute Consultation / Medical History Form

[mcafton]

I am just starting out in business next week and I intend to offer many 10-minute free taster sessions as well as a regular Acupressure / oil-free paid session for 15 minutes etc.

The treatements will be mainly:
Indian Head massage
Shiatsu Facial massage
Sport therapy massage
Thai and Shiatsu Acupressure
Hand Reflexolgy

I hope to compile a VERY SHORT perhaps 5 question Medical Consultation form.

So far I was thinking along the lines of:

Medical History - Strictly confidential
Name, DOB & Contact telephone number

1/. Any infectious disease, headache or current fever?
2/. Any skeletal or joint issues?
3/. Any circulation or Cardiac issues?
4/. Any respiratory issues or allergies?
5/. Any dysfunction of the nervous system? Epilepsy?
6/. Are you taking any medication or natural remedies?
Are there any other conditions or medical issues that I should be aware of?

I have provided all information to the best of my knowledge and consent to treatment:
Signed: Dated:

Can I shorten this even further? Any suggestions will be much appreciated.

When I finnish it off, I shall approach my own insurance for their approval.

 

[Puppy808]

Why not just display a laminate containing a simple list of contraindications - ask if the client has any of the listed conditions and if they don't then treat them. For such a short treatment you only need their name, address and contact details - then you can follow up with any offer for more treatments and do a longer history.

 

[Lorna]

Thanks JTH,
I like the idea of a laminate - always happy saving the Wood

Didn't realise that I need their actual address? I thought only to take contact phone number and email - if they have one. As you say, I will then follow up with special discounts and promotions.

 

[Brethermed]

It doesn't appear to be a legal requirement for tasters to take postal address email address, but if they are happy to give it, then encourage them to write it down, with a note on the form stating that the details will not be made available to a third party.

 

[kiwikid]

My dh does a fair bit if osm at sports events (he's an athletics coach) and he uses a laminate as well. He also has pregnancy and recent injuries on his

 

[Marykate]

I think, (tho don't quote me on this), that it's to do with the bladder meridian when he is doing osm/ upper body work.

 

[mpbfzulf]

Word of warning, I have never had any business from giving free tasters.

 

[*ZOEY*]

Thanks for the warning, Kevin - much appreciated.
I am in a slightly more advantageous position as I will be giving free tasters at the gym, which is a level above where I work / rent a room. Hopefully, the gym goers, who will see my leaflets and posters almost daily, will be able to attach a face and a 'feel' to my literature

 

[bookmakermalta]

Hi manulike

I can let you have copies of my basic forms

Have PMed with email address

Jaez

 

[Khun Bob]

I have.....

We have a victorian evening in our town centre and I do tasters in the shop window. Last year everyone who had a taster booked. So I guess it depends on the occasion.

Myarka.

 

[Waverly H]

Are you well, are your bowels moving, are you receiving other treatment, have you had any injuries or operations, what symptoms do you have and where does it hurt?

 

[Carla Contreras]

Hi MUL

Why offer such a diverse list of therapies for taster treatments? Wouldn't it be better just to offer one or two therapies, otherwise you could be confuse people with such choice. For example if this is a gym you are working at just offer: neck, shoulder, back and limb massage and state that you specialise in sports injuries. It doesn't matter if the technique you use is eastern or western, if it is effective then you would have better success, and hopefully they will book for a longer treatment.

Later this month I going to work at a festival doing half hour treatments. My sign is going to say:

(Big letters) DEEP TISSUE ORIENTAL MASSAGE
(Small letters) Thai, Chinese & Indonesian Bodywork for pain relief; sports injuries; back, neck, shoulder & joint mobility

Simple and to the point.

Best Wishes

RP

 

[om nom nom nom nom]

Hi RP,
Once again, very sound advice.
Fortunately, I have not yet printed my A2 posters...
Am very tempted to copy your poster almost word to word (with your permission, of course)

 

[Sookie]

Hi MUL

I'm happy to share, but it is for a festival where they like that type of stuff, please keep that in mind. Not forgetting that Oriental is my speciality if you have seen my website (which you can get free for two years from www.gbbo.co.uk) . Each situation may need diffferent marketing.

The logic is this: what is it that people what, and can you be all things to all people?

Well most people want massage for stress & pain relief, chronically held patterns of tension, backache, sports injuries and so forth. You can't be all things to all people but you can provide a service to the clientele of the gym that supports their fitness & sporting endeavours. But when you have given them a treatment and gained confidence in you, then you can give them treatment options.

Here's another idea: offer 10 min free assessment for there problems, ie tight hamstrings and then demonstrate a PNF or Thai stretch for it. Feeling the difference is believing!

Best Wishes

RP