
Ear candling session? If so, what did you enjoy most and least about the candling? Yes No What results are you looking for as a result of your session today? Health Related: Are you presently under a Doctor or Therapist s care? Yes No If so, why? Do you wear any type of hearing aid? Yes No Check the following symptoms that you have or had previously experienced: Ear Aches Headaches Ringing in Ears Ear Discharge Dizziness Loss.
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How to fill out the MA Valley Massage Therapy Ear Candling Consent Form online
Completing the MA Valley Massage Therapy Ear Candling Consent Form online is a straightforward process that ensures you provide all necessary information for your ear candling session. This guide will walk you through each section of the form, helping you fill it out accurately and efficiently.
Follow the steps to complete the consent form with ease.
- Click the 'Get Form' button to obtain the form and open it in your preferred editing tool.
- Enter the current date at the top of the form in the designated field.
- Fill in your name in the specified section, ensuring it matches your identification as needed.
- Answer the questionnaire about your previous experiences with ear candling, checking either 'Yes' or 'No'. If applicable, share what you enjoyed most and least about your prior sessions.
- Indicate your goals for the session today in the provided area, focusing on health-related outcomes.
- Answer whether you are currently under a doctor's or therapist's care, marking 'Yes' or 'No'. If 'Yes', briefly note the reason.
- Specify if you wear any type of hearing aid by selecting 'Yes' or 'No'.
- Check any symptoms you have experienced from the list provided, including ear aches, headaches, or excessive ear wax, if applicable.
- Provide any additional general health concerns that may be relevant for your ear candling session.
- Read the consent agreement thoroughly and ensure you understand the terms. By signing, you acknowledge the information provided is accurate and release the therapist from liability.
- Sign and date the form in the designated sections.
- If you are completing the form for a minor, authorize treatment by signing again and including the date.
- Finally, save your changes, and choose to download, print, or share the form as necessary.
Complete your forms online for a seamless experience with your ear candling session.
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