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If you have a reflexology or reiki appointment, I would appreciate you taking the time to complete the following consultation form and submit it back to me at least 48 hrs prior to your appointment to ensure the best possible results from your treatment. Any questions or concerns will be discussed at your appointment.

All information given is private and confidential and protected under the GDPR. 

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Thank you and I look forward to meeting you.

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Lucy

Consultation Form

Please fill out the following form
prior to your appointment.

Have you been hospitalized in the last 12 months?
Are you suffering from a medical condition, illness, or injury?
Do you have/ever suffered with any of the following conditions?

Lifestyle:
 

Thanks for submitting!

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