"*" indicates required fields

Name*
Address
Have you had a DEEP TISSUE or SPORTS massage before?*
Did you experience any bruising following your last deep tissue massage?*
Medical history (check all that apply)*
Please tick the areas of your body that you wish me to focus upon in your massage session(s) (please understand that there is a limit to what can be achieved in 1x30min or 1x60min session)*
I understand that I may experience side effects to deep tissue massage including but not limited to (bruising, stiffness, soreness of any kind, congestion, dizziness, fatigue, confusion, dehydration, build up of toxins, nausea) and I accept that these can be normal side effects of a treatment.*
You will be sent a copy of Rossell Fitness Massage aftercare information to give you the correct and safe guidance that you need to get the best out of your treatment!
Emergency contact*
I confirm that the above information is correct to the best of my knowledge. I understand what I am undertaking with a deep tissue massage and give my consent to the treatment and to be contacted by Rossell Fitness. I understand that there is a limit to what can be achieved in one session of deep tissue massage and accept that I may have to consider further treatment. I am happy to accept rehabilitation guidance from my massage practitioner and accept that the effectiveness of the massage and subsequent satisfaction is determined by how I choose to act in the hours/days following the treatment. I give my consent to be contacted using the information I've provided in this questionnaire*
Thanks for filling in my form and I will be in touch very soon! I recognise that I am freely giving my contact details to Rossell Fitness, and that my details WILL be used to contact me regarding my request and other related services. I give my full consent for this. Your data will be protected and never shared with third-party companies. In accordance with GDPR regulations, you are entitled to request to see what information is held about you, opt out of any communication at any time and change any information we hold. We will comply with your request within the designated time frame.