Health Form

Re:source is not responsible for any pain or injury caused by the practice. All students are advised to work
within their range of ease, and within their own limitations.
Please note that the cancellation policy ensures 24 hours warning prior to change, or cancellation of an
appointment. Any cancellation effected within the 24 hrs prior the session will be charged at full fee.
Thank you for helping us serve you best.
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    Diet

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    Please comment on digestion

    constipation, bloating, excess, etc.
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    Sleep

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    Women

    Comment on period/menopause:
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    Please describe the conditions associated with the following:

    (if there is nothing noteworthy, leave space blank)
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    Is there anything you feel is important that has not been covered?

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