Get In Touch

Book Your

Session.

Call or Text

07712 281400

Call or text to book or ask a question

Email

[email protected]

Email to book or ask a question

Availability

Mon – Fri, 09:00 – 19:00

Appointments outside these hours may be possible — a call-out charge may apply

Service Area

Mobile — I come to you

Covering Littlehampton & Worthing

Notice: The information provided in this form is confidential and used solely to ensure your treatment is safe, effective, and tailored to your specific needs. Please complete all sections as accurately as possible.

Mobile Sports Massage & Soft Tissue Therapy

Client Intake Form — please complete all sections before your first session.

1. Client Information
2. Lifestyle & Physical Activity
Physical Demands of Job
Primary Goal for Today's Session *
3. Medical History & Contraindications

Please indicate Yes or No for each condition (past or present).

ConditionYesNo

Cardiovascular

High / Low Blood Pressure
Heart Conditions / Pacemaker
Deep Vein Thrombosis (DVT) / Blood Clots

Circulatory

Varicose Veins / Easy Bruising

Neurological

Epilepsy / Seizures
Nerve Damage / Sciatica / Numbness

Musculoskeletal

Osteoporosis / Arthritis
Recent Fractures / Dislocations / Sprains
Joint Replacement / Metal Implants

Other

Open Wounds / Cuts / Rashes / Contagious Skin Issues
Cancer / Tumours (Current or Past)
Allergies (Oils, Nuts, Latex, Creams)
Currently Pregnant?
4. Symptom & Pain Map
Symptom Type
1 — Low5 — Moderate10 — Severe
5. Client Consent & Policy Agreement
6. Client Signature & Confirmation

By completing this form, I certify that I have read, understood, and accurately completed this intake form to the best of my knowledge. I consent to receive soft tissue treatment under the terms outlined above.

Service Area

Where I Work

All sessions are delivered at your chosen location — no need to travel to a clinic or studio. I bring everything required for a full treatment directly to you.

I currently serve clients across Littlehampton and Worthing. If you're unsure whether your location falls within the service area, just ask when you get in touch — I'll always do my best to accommodate.

Locations I visit

  • Littlehampton
  • Worthing

A small travel supplement may apply for locations outside the standard service area. This will always be confirmed before booking — no surprises.

Not sure what you need?

Browse the services or check the pricing page before getting in touch.