Anamnesis form

In order to optimise the massage to your needs, I need some information about your current state of health. This helps me to avoid risks and to organise the treatment safely and effectively.

If you have to postpone a massage for health reasons - such as pregnancy, infection or skin problems - please let me know in good time. I will be happy to help you if you have any questions.

Thank you for your support!

Julia from Elisa Bernschein Wellness Massages

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Name

Why did you book a massage?

Your state of health

Additional information & questions

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All information, especially regarding my health, was answered truthfully

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I consent to my details being stored and processed for the purpose of the medical history. I have read and accept the terms and conditions & privacy policy