Your health history is being requested for your safety and security. Your response to the following questions will help me create a personalized session, specifically catered to your requirements. All the information you provide will be kept confidential between client and therapist.
Disclaimer:
All of the information is to be correct and to the best of my knowledge. I realize that this session is not intended to diagnose or treat any medical condition that I may have and is solely for therapeutic purposes. I will not hold the therapist liable for any exacerbated condition that was not disclosed in the below questionnaire. The following therapy will take place at my own risk and the therapist will not be held accountable for any post injuries.