Reflexology Consultation Forms
When I started practicing as a Reflexologist, I wanted to be able to record all the necessary information in one place, which could be filed and easily reviewed each time the client returned. Over time, this has changed, been added to and refined and I find the format I have arrived at enables me to quickly refresh my memory on the client, past treatments and strategies.
I like to work with the form on a clipboard on the table beside me as it is stable and easy to fill out during the treatment without losing touch with the client's feet, using a coloured felt tip pen to mark the foot chart.
The 3-page form is printed in gummed pads of 60 pages (20 sets) and also pads of 30 continuation sheets page 3 of the form.
The from provides space to record the following information:
Page 1:
Full personal details, medical history and medication
A general health questionnaire with space to record comments
Page 2:
Family Medical History
Presenting problems
Condition of feet with chart and space to record comments
Page 3:
Sheet with four diagrams of the feet on which to record treatment observations.
To the left there is space for comments, observations and outcomes and to the right, room to record treatment strategies used.
This forms the last page of the 3-page Consultation Form and can also be bought in gummed pads of 30 for use as continuation sheets for regular clients.
New Prices
£7.50 for a 60 sheet pad (i.e. 20 sets of the three-page form)
£3.50 for a 30 sheet pad of continuation sheets (page 3 of the form)
Please allow 3-5 days for delivery.
For large orders please contact us for postage and packaging details.