PARQ | Vegan Sports Therapist

What are your main reasons for wanting a sport therapy massage?

Do you have or have you had in the last six months, any of the following listed conditions?

Please indicate if you ever experience any of the following symptoms. Do you:

Ever get unusually short of breath with very light exertion?

Ever have pain

Regularly have unexplained pain in the abdomen

Ever have severe dizzy spells or episodes of fainting?

Regularly get lower leg pain during walking that is relieved by rest?

Ever experience palpitations or irregular heartbeats?

Are you currently pregnant or have you given birth in the last 6 month

None of the above

NEW SPORTS MASSAGE THERAPY CLIENT FORM