Consultation Form

Please complete this form prior to your appointment at Spring.

Your information will be collected and stored in accordance with our privacy policy.

Location

Full Name

Email Address

Phone Number

Suburb, City

Current Conditions

Pre-existing Conditions

Are you pregnant or planning to become pregnant?

If yes, how many weeks are you?

How are you feeling today?

Any current concerns we should be aware of?

Any specific focus areas for your therapist?

I do not have symptoms of COVID-19

I confirm, to the best of my knowledge, that the answers I have given are correct.

I have not withheld any information that may be relevant in determining how my treatment is carried out.

I acknowledge that Spring accepts no liability for any injury or damage as a result of any treatments received.

I agree to the terms above