Consultation Form Download

Please download and save the consultation form to your computer and complete as much as possible before emailing directly to Please include a telephone number as sometimes email addresses can be misspelt.


In line with the new General Data Protection Regulation (GDPR) as of May 2018, I ask you to complete a consultation form to allow me to have your address, telephone number and email address in case I need to contact you in relation to your appointments. I also need to know a bit about your lifestyle and medical history, and why you would like to book a reflexology treatment with me. This will allow me to make sure that I personalise the treatment to give you the best possible outcome. Anything you tell me is in the strictest of confidence, I never share it with anyone, and make sure printed information is stored under lock and key, and electronic is password protected on my computer. I like to keep my records for 7 years for insurance reasons, but you can ask me to destroy or delete your personal information at any time. If you have any questions regarding this please just email or phone me directly.

Thank you.