Health Declaration

Please fill out the following at least 24 hours before your appointment.  Thank you in advance.
Select any medical conditions that apply
What is your reason for booking a treatment
Are you experiencing any flu symptoms?
How your information will be used: I take your privacy very seriously; your personal information will only be used for treatment purposes and will never be shared with any third parties, without express permission. Keeping in touch: From time to time, I would like to get in touch with you when I have information about new therapies and special offers that I think might be of interest to you. If you agree to being contacted in this way, please tick how you are happy to be contacted. You can change your preferences at any time by contacting me.

Thanks for submitting!