Returning Client Check-In Form | Zenthai Shiatsu Brisbane | Pablo Guzman

Returning Client - Check-In Form

This quick check-in helps me understand how your body is feeling today and what’s shifted since your last session.

It ensures the work is attuned to your needs in this moment — grounded, effective, and supportive. Thank you for taking your time.

Returning Client Check-In Form

First Name

Last Name

What would you like us to focus on in your upcoming session?

Where do you feel it most in your body?

Head / Jaw

Neck / Shoulders

Upper Back

Lower Back

Hips

Arms / Hands

Legs / Feet

Full Body

Stressed / Burnt Out

Emotional Overwhelm

Other

Have there been any noticeable changes since your last visit? If yes, please share:

How would you describe your current stress levels?

Extremely High

High

Moderate

Low

How would you describe your energy levels lately?

Solid

Up and Down

Fatigued

Running on Empty

How is your sleep currently?

Good

Light / Fragmented

Poor

Insomnia

Is there anything else that you would like me to know before our next session?

How would you prefer the session to feel?

Pressure Preference

I understand that Zenthai Shiatsu is a non-medical, holistic therapy. I take responsibility for communicating any discomfort or concerns at any time during the session.

I consent to have this website store my submitted information so they can respond to my inquiry.

Thank you & See you soon.