Consultation Form

Consultation Form

Genies Touch, believes that every exceptional treatment begins with understanding you. This confidential consultation allows us to tailor your experience to your individual needs, ensuring each massage is thoughtfully designed to support your wellbeing, relaxation, and overall balance.

Your comfort, privacy, and care are at the heart of everything we do. All information provided is treated with the strictest confidence and enables us to deliver a safe, personalised, and truly restorative experience from the moment you arrive.

Consultation Form | Genie's Touch
Genie's Touch
1 of 8 — Personal Information
We found a saved consultation in progress. Would you like to resume where you left off?

Step 1

Personal Information

Let's start with a few details so we can look after you properly.

Step 2

Health Questionnaire

Please select anything that applies to you. This helps your therapist keep you safe.

Please noteYour therapist will review your consultation before treatment to ensure it's suitable during pregnancy.
Please noteRecent surgery may affect which techniques and areas can be treated today.
GP / consultant approval may be requiredPlease bring written approval from your GP or consultant where appropriate before treatment.
Please noteYour therapist will take extra care and may adapt pressure and positioning for your heart condition.
ImportantBlood clotting disorders can affect the safety of massage. Please discuss this with your therapist before treatment begins.
0/600

Step 3

Medication

Are you currently taking any medication?

0/500

Step 4

Massage History

Have you had a massage before?

Step 5

Today's Treatment

Reason for your visit

Areas requiring treatment

Step 6

Pain Assessment

Are you currently experiencing pain?

0
0 – No pain10 – Worst pain

Step 7

Lifestyle

A little about your daily routine helps us tailor your treatment.

Stress level

Exercise

Water intake

Sleep

Occupation type

Step 8

Pressure Preference & Consent

Preferred pressure

Deep tissue confirmedDeep tissue work uses firm, targeted pressure and may cause mild tenderness for a day or two afterwards.

Consent

Your progress is saved automatically on this device.

Allergies & Sensitivities

Your safety is our highest priority. Please let us know about any allergies or sensitivities so we can tailor your treatment and avoid products or techniques that may cause a reaction.

Do you have any allergies or sensitivities?

Please let us know whether you have any allergies or sensitivities.

Thank you — your details are ready to send. Your email app should now be open with a message addressed to info@geniestouch.co.uk; please press send to complete your submission.

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