Mana Massage Beenleigh

8a/20 Main St, Beenleigh QLD 4207
(Post Office Plaza)
0466424641
Please note, our phone is not answered during the day while treatments may be in progress. We will get back to you ASAP.

Intake and Consent form

This is your client intake and consent form, you can submit one for each appointment with us. Filling this in online now, allows us to get a little deeper into your intent for the session, while also saving us some time during your appointment later. However, we will still have a discussion at the start of your session to make sure we are on the same page and everyone feels comfortable. If you prefer to only do this in person that is ok too just come along to your booking and we will sort it out then.

Client Intake & Consent Form
If you've already forgotten, you will find this in your confirmation email
We will always try to accomodate your prefrence, however sometimes only phone appointments are possible.
(We are not currently offering bodywork services suitable during pregnancy)
Tell me all about it, any soreness or tension as much or as little detail as you like
(Full body lomi lomi will typically include- Back, Legs front & back including glutes, neck, head/hair, face, stomach, arms and hands, chest including breast- not including nipples *NOTE that genitals are NEVER treated will be covered/draped at all times)
Tell me all about it! What's coming up? How are you feeling? Why are you here? Give as much or as little detail as you feel like sharing today
What are we going to be working on together? This can be very specific or general, no wrong answers "to relax" "to ease sore muscles" "to let go" "to be held while I do the work" "to release (fill in the blank) safely", "to try something new", "to fill my cup", "to offer space to my heart", "to find some peace/stillness" or also tell us what you've been struggling with lately, something we can throw some energy towards together.
Let us know if you have flexibility in your finish time, sometimes (though it isn't a guarantee) we may be able to/ feel the need to extend the session where appropriate
Tick all that you might be interested in/open to, we will still chat at the start of your appointment to ensure we're on the same page for each specific session. (please note that if you require a different oil other than coconut oil - due to allergies or preference- please arrange this ahead of time, we may only have Coconut available otherwise)
Select any applicable
Keep us up to date and let us know if anything has changed since your last visit.
A Lomi Lomi treatment traditionally attends to the whole body, head to toe to fingertips (with the exception of genitalia). If you have any concerns, please discuss them prior to the commencement of your massage. -I understand that the massage I receive is provided for the basic purpose of relaxation and relief of muscular & emotional tension. When I experience any pain or discomfort during the session, if necessary, I will inform the therapist so that the pressure and/or strokes may be adjusted to my level of comfort. I further understand that massage should not be construed as a substitute for medical examination, diagnosis, or treatment. I understand that Massage 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. -Massage should not be performed under certain medical conditions, as such, I affirm that I have stated all my known medical conditions and answered all questions honestly. I agree to keep the massage therapist updated as to any changes in my medical profile prior to the session and understand that there shall be no liability on the Massage Therapists part should I fail to do so. I also understand that the Massage Therapist reserves the right to refuse to perform massage on anyone whom he/she deems to have a condition for which massage is contraindicated. -Warm/Hot stone therapy is a form of Thermotherapy treatment. Your therapist will monitor the temperature of the stones at all times, however, it remains the responsibility of the client to let your therapist know if there is any discomfort during the treatment. Failure to do so waives all liability of the therapist.
IN CONSIDERATION of my payment for participating in the activity provided by Tara Owens (and the extent that the same may be precluded by statute) I ACKNOWLEDGE AND AGREE TO RELEASE AND INDEMNIFY the Lomi Lomi Practictioner as follows: 1. I participate in the activity at my own risk and responsibility. 2. I release, indemnify and hold harmless the Lomi Lomi Practitioner from and against all actions or claims that may be made by me or on my behalf by other parties in respect of or occurring from an injury, loss, damage, or death caused to me or my property whether from negligence, breach of contract or in any way whatsoever or any liability that results from the breach of an express or applied warrant that the treatment will be rendered with responsible care or skill. 3. In the event that I am injured, or my property damaged, it will bring no claim, legal or otherwise, against the Lomi Lomi Practitioner in respect of the injury or death. By signing this document, I acknowledge that I have read and understood all content and know that it affects my legal rights. 4. (If receiving Hot Stone Massage) I am aware of the extreme temperature used in this Hot stone treatment, and hereby consent to assume all responsibility to communicate the slightest bit of discomfort or pain to my therapist. I hereby agree my therapist has explained this treatment to me and my failure to let her know, waives all liability to the therapist giving the treatment
My therapist works within the Australian Code of Conduct for Healthcare Workers and adheres to both the COAG Health Council Communique and the National Code of Conduct 2015. We provide our our treatments in accordance of ‘The IICT Code of Ethics’. Copies of these codes are available through the following link: https://1drv.ms/u/s!AkpAwz9BGcW2qcNwkraZi4cAbXeVWA?e=tRPu9a or copies available upon request.
I sign my name acknowledging that all the above information provided in this form is all true and correct and I understand my responsibility in my own healing. If I have any questions or concerns, I know that I can contact Tara to discuss prior to my appointment OR I can discuss at my appointment to make sure I am happy and comfortable moving ahead with the session.
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