Massage Registration

/Massage Registration
Massage Registration2018-11-04T11:31:33+00:00

Thank you for choosing active X massage. I’m delighted to welcome you.

The code of practice of the Scottish Massage Therapists Organisation requires each therapist to enter into a one-to-one contract with their clients in the form below. If you have any questions or concerns in connection with the contract or your treatment, please don’t hesitate to contact me at gavin@active-x.co.uk or on 0131 221 1415.

PRIVACY NOTICE

Active X Clinics is the data controller responsible for the processing of your personal and sensitive data, and Gavin Routledge is Active X Clinic’s data protection officer.  We process your data in order to provide you with an appropriate clinical service and to communicate with you about relevant services, and you consent for us to do this, although you have the right to withdraw your consent at any time. Your information will only be shared with members of the active X team, unless required to do otherwise by law (exceptions). Your information will be retained for at least 7 years after your most recent visit to us or contact with us.

You have the right to access your information and to have it erased.  You also have a right to complain to the Information Commission Officer about the way in which your data is handled.

Thank you very much for taking the time to register online. The below form is confidential and all information will be held in the strictest confidence by active X clinics. Please fill in all appropriate fields as this information helps us greatly to manage your health and to run our business efficiently in order to deliver the best service possible. If you’re unable to register online prior to your first appointment, please arrive at the clinic ten minutes early in order to complete the form then.

We look forward to providing you with a fabulous massage, and ensuring that you feel great!

Best wishes,

Gavin Routledge
Clinic Director

PS Please wear appropriate underwear to your appointment.  Towels will be used to preserve your modesty.

Patient Information

  1. You will be seen by a qualified therapist registered with the Scottish Massage Therapists Organisation, who will be fully responsible for your care.
  2. The therapist needs to know about your past and present health and you will be asked detailed questions about your complaint, medical history, general health and any medication you may be taking. You agree to provide this information.
  3. If you have any concerns at any time during the appointment, you agree to ask the therapist to stop the treatment and explain anything he/she does.
  4. After treatment, the therapist may give you further advice regarding the management of your health.
  5. You may feel some discomfort for the first 24 to 48 hours after treatment, but if your discomfort feels excessive please feel free to telephone the clinic and talk to your therapist.
  6. You consent to active X clinics sharing your clinical notes with our other clinicians, for the benefit of your treatment/care.

Registration - Massage

Including postcode

A BIT MORE ABOUT YOU

CLINICAL - When you come for your appointment, we want to spend as much time as possible delivering your treatment. Please answer the questions below to give us a head start.

CONFIRMATION & CONSENT

By submitting this form you are certifying that your answers are correct and that you accept our terms as set out above.