I understand that the Manual Lymphatic Drainage I receive is provided for the basic purpose of improving the flow of my lymphatic system and also for relaxation. If I experience any pain or discomfort during this session, I will immediately inform the practitioner so that the pressure and/or strokes may be adjusted to my level of comfort. I further understand that massage or bodywork should not be construed as a substitute for medical examinations, diagnosis, or treatment and that I should see a physician, chiropractor, or other qualified medical specialist for any mental or physical ailment of which I am aware. I understand that massage/bodywork therapists are not qualified to perform spinal or skeletal adjustments, diagnose, prescribe, or treat any physical or mental illness and that nothing said in the course of the session given should be construed as such. Because massage/bodywork should not be performed under certain medical conditions, I affirm that I have stated all my known medical conditions and answered all questions honestly. I agree to keep the practitioner updated as to any changes in my medical profile and understand that there shall be no liability on the therapists part should I fail to do so. * Please note- Manual Lymphatic Drainage (MLD) is a very powerful modality and certain medical conditions are contraindicated and determine if or when, you can receive a treatment. After the consultation and review of the information you have provided on this form, it will be determined if MLD should be advised as a treatment for you today. Some conditions will require a note from your doctor before proceeding. Please understand this for your safety & well-being.
The advanced treatments may cause instant reactions to the skin including skin redness and flushing, tightness, itching, sensitivity and pinpoint bleeding. Effects will usually typically resolve within hours, but some people react differently and may take slightly longer. The use of a sharp instrument creates a possibility of nicks and cuts whilst every precaution is taken I do understand the risks. I confirm that to the best of my knowledge that the information that I have supplied is correct and that there is no other medical information I need to disclose. I understand that I may require a series of treatments normally with at least 2-4 weeks between procedures, to achieve the maximum desired results. I have been given post treatment advice and understand to agree to follow all the guidance to minimise the risk of side effects. I give full consent to use my before and after pictures to be taken and used for marketing purposes.
Read this document carefully & if you agree that you have read this information. Please see below. Prior to your appointment you will receive an electronic consultation form to fill in before your treatment. Please ensure that this is completed before you arrive for your treatment. A verbal consultation will commence before treatment to ensure that the treatment is specifically tailored to your needs. Everything about the above-named procedure to your satisfaction, have checked that the information on this and the client registration form are correct and consent, sign below. I authorise and consent to treatment for improving the appearance of cellulite/ skin tightening using the procedure. I have been advised of the advantages and disadvantages associated with the above procedure and I agree that the therapist has adequately explained the proposed procedure and alternatives. I understand that treatment experience and results with this procedure varies from client to client and as with all beauty therapy procedures, no guarantees can be made regarding the eventual outcome. I understand that the primary benefits are for personal effect and not for medical or essential health reasons. I am satisfied that I have had enough 'cooling off' opportunity to enable me to make a rational decisions. I accept that cosmetic improvements are secondary to a healthy lifestyle and sensible diet & that exercise regimes must be maintained. I have been given enough opportunities to ask questions and seek further information and have received satisfactory answers to all of them. I accept, although rare, that adverse outcomes such as pain, bleeding, bruising, infection, numbness, scarring and lumps may occur. I am aware that with the relatively new procedures, there are no long term studies on adverse effects and complications. I authorise the taking of photographs. I understand that the use of such equipment is optional and entirely at my own risk. I have completed a medical questionnaire and can confirm that all information is correct.
© 2025 Naturelle by Elle