James the Rolfer™
07769681685
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Rolfing® Intake Form
Please fill in this form to get the most from your Rolfing sessions.
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Indicates required field
Name
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First
Last
Phone Number
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Email
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Age (not a required field, but it is useful info for me)
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Are you pregnant? (Please let me know if you become pregnant, even if it's early days)
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Yes
No (Men please take this option)
Please tell me why you have decided to come for Rolfing. Please include the things you are looking for help with.
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Let me know about your general health.
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If there's anything else that you want to let me know or ask me, use this box.
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Terms and Conditions
Cancelation Policy
I really appreciate 48 hours notice of cancellations. For cancellations with less than 24 hours notice (short notice) and for no-shows, I charge £20 to cover room hire costs and my time. The £20 charge is important for maintaining a good therapeutic relationship, so please use the bank details in my booking email to make payment in event of a short notice cancellation or no-show, then contact me to rebook.
Paying for sessions in advance
If you decide to pay in advance for 10 or 4 sessions then change your mind about working with me, I charge my full rate for the sessions we have done and refund the balance upon request.
Terms and Conditions agreement
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I agree
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