Client Consultation Form – Body Treatments
College Name: Kerry ETB Training Centre.
College Number:
Learner Name: Alyson O Connor.
Learner Number:
Date: 19/5/18
PERSONAL DETAILS
Age group: Under 20
20–30 30–40
40–50
Lifestyle: Active Sedentary
Last visit to the doctor: four months ago
GP Address: Oakpark medical centre
No. of children (if applicable): 0
Date of last period (if applicable): 2 weeks ago
Client Name: Emer O Sullivan
Address: 21 St Brendans Park, Tralee
Profession: Student
Tel. No: 0835448460
50–60
60+
CONTRAINDICATIONS REQUIRING MEDICAL PERMISSION – in circumstances where medical
permission cannot be obtained clients must give their informed consent in writing prior to treatment
(select if/where appropriate):
Pregnancy
Any dysfunction of the nervous system (e.g.
Cardio vascular conditions (thrombosis, phlebitis,
Muscular sclerosis, Parkinson’s disease, Motor
hypertension, hypotension, heart conditions)
neurone disease) Bell’s Palsy
Haemophilia
Trapped/Pinched nerve (e.g. sciatica)
Any condition already being treated by a GP or
Inflamed nerve
another practitioner
Cancer
Medical oedema
Postural deformities
Osteoporosis
Spastic conditions
Arthritis
Kidney infections
Nervous/Psychotic conditions
Whiplash
Epilepsy
Slipped disc
Recent operations
Undiagnosed pain
Diabetes
When taking prescribed medication
Asthma
Acute rheumatism
CONTRAINDICATIONS THAT RESTRICT TREATMENT
Fever
Contagious or infectious diseases
Under the influence of recreational drugs or
alcohol
Diarrhoea and vomiting
Skin diseases
Undiagnosed lumps and bumps
Localised swelling
Inflammation
Varicose veins
Pregnancy (abdomen)
Cuts
Bruises
Abrasions
Scar tissues (2 years for major operation and 6
months for a small scar)
Sunburn
Hormonal implants
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(select if/where appropriate):
Abdomen (first few days of menstruation
depending how the client feels)
Haematoma
Hernia
Recent fractures (minimum 3 months)
Cervical spondylitis
Gastric ulcers
After a heavy meal
Conditions affecting the neck
Any metal pins or plates
Loss of skin sensation (test with tactile test)
IUD (coil)
Anaphylaxis
Muscle fatigue
Pacemaker
Body piercing
Excessive erythema
WRITTEN PERMISSION REQUIRED BY:
GP/Specialist
Informed consent
Either of which should be attached to the consultation form
PERSONAL INFORMATION (select if/where appropriate):
Muscular/Skeletal problems: Back Aches/Pain
Digestive problems: Constipation
Circulation: Heart
Kidney problems
Stiff joints
Headaches
Bloating Liver/Gall bladder
Blood pressure
Fluid retention
Stomach
Tired legs
Varicose veins
Cellulite
Cold hands and feet
Gynaecological: Irregular periods
P.M.T
Nervous system: Migraine Tension
Menopause
H.R.T
Pill Coil
Other:
Stress Depression
Immune system: Prone to infections Sore throats
Colds
Chest
Sinuses
Regular antibiotic/medication taken: No
Herbal remedies taken: no
Ability to relax: Good Moderate
Sleep patterns: Good Poor
Poor
Average No. of hours: 8
Do you see natural daylight in your workplace? Yes No
Do you work at a computer? Yes No
Do you eat regular meals? Yes
If yes how many hours: 3
No
Do you eat in a hurry? Yes No
Do you take any food/vitamin supplements? Yes
No
How many portions of each of these items does your diet contain per day?
Fresh fruit: 2 Fresh vegetables: 1 Protein: 2 source? Chicken eggs
Dairy produce: 1 Sweet things: 3 Added salt: 0 Added sugar: 2
How many units of these drinks do you consume per day?
Tea: 3 Coffee: 2 Fruit juice: 0 Water: 2 glasses Soft drinks: 0 Others: 1-2 energy drinks
Do you suffer from food allergies? Yes
Overeating? Yes
No Bingeing? Yes No
No
Do you smoke? No  Yes
How many per day?
Do you drink alcohol? No
Yes How many units per day?
Do you exercise? None Occasional
What is your skin type? Dry
Oily
Irregular
Hay Fever
Asthma
Skin cancer
Stress level: 1–10 (10 being the highest)
At work
5
At home
2
TESTS
Nerve sensitivity test: Yes No
Heat sensitivity test:
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Yes No
Types walking and running
Combination Sensitive Dehydrated
Do you suffer/have you suffered from: Dermatitis
Allergies
Regular
2
(Result Normal)
(Result Normal)
Acne
Eczema
Psoriasis
BODY ANALYSIS
Height: 165.5cm
Weight: 85kg
Body type/conditions: endomorph
Areas of cellulite: thighs
Postural conditions: lordosis. She leans more to
left side.
Areas of soft fat: abdomen, arms, thighs
Poor muscle tone – abs
Stretch marks – inner thighs
MEASUREMENTS:
Upper chest (under the arms): 93cm
Maximum chest: 103cm
Below bust: 91cm
Waist: 88cm
Hips: 107cm
Maximum buttocks (on hairline): 112cm
MUSCLE TEST (select if/where appropriate):
Quadriceps: Excellent
Good Average
Poor
Hamstrings: Excellent
Good  Average Poor
Biceps:
Excellent
Good
Average Poor
Triceps:
Excellent
Good Average
Poor
Abdominal: Excellent
Good
Average Poor
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Top of thigh:
R: 68
1 inch/2cm above knee: R: 48
Maximum calf muscle: R: 40
Ankle:
R: 23
Middle of upper arm:
R: 31.5
Middle of lower arm:
R: 25
Wrist:
R: 17
L: 70
L: 45
L: 41
L: 23
L: 31.5
L: 24
L: 17.5
EXERCISE ADVICE: Please see attached to the end of the case study.
Client Profile.
My client Emer is a 21 year old full time student. She has college 5 days a week and does not see
much daylight when in college. She works at a computer for several hours a day and for a few hours
in the evening also when she is studying. She gets a lift to and from college everyday so she has to
rely on friends and family from lifts which can be stressful some days when she finds it hard to find
a lift.
Her sleep patterns are good as she gets an average of 8 hours a night. Her ability relax is good and
she spent a lot of time watching television. She tries to fit in a good nights study every evening
along with doing household tasks and having time with family.
Emer has a healthy enough diet where she has a good intake of fresh fruit and veg and a high
protein diet. If she gets peckish in the evenings she will look for sweet things and she might have 3
sweet things a day which are very high in sugar. She drinks alcohol very rarely and does not smoke.
My client has a lot of soft fat on areas of her body such as her things, arms and abdomen. She has
hard fat on her outer thighs and cellulite on her thighs also which she is very conscious of. The
cellulite on her legs is her main area of concern and she also has stretch marks around the cellulite
also. With Emer’s posture I could see that she has lordosis and also leans more to the left side.
Treatment Details.
From our consultation and figure analysis we have decided to use the G5, Galvanic and
microcurrent. I started by positioning my client on the bed and sanitizing her feet with surgical
spirits. Next I performed a skin sensitivity test and the results were normal. I started by sanitizing
the area to be treated using surgical spirits and dried the area. I set up my machine and sanitized as
I explained the treatment to my client.
G5 – Gyratory vibrator.
I began by using the G5 as a pre heat treatment. This is the Carlton Professional and is used as a
mechanical massage. It is connected to the mains supply that runs a motorised pump. It has a
cooling system that stops the machine overheating. It has several different types of applicator
heads:
 Sponge heads are used for effleurage
 Hard rubber heads are used for petrissage
 Spiky or brush heads are used for tapotement
 Lighthouse applicator is used for frictions
G5 has many effects on the body:
 It helps relax tense muscles
 Eases muscular pain
 It improves lymphatic flow and aids the removal of waste products
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It stimulates the circulatory system, increasing blood supply to the area being treated, so
providing nourishment to the skin
 It has a desquamating effect on the surface of the skin
The advantages of this treatment is that it can produce a depth of massage far greater than that of
manual massage, and is a far less personal treatment than manual massage which might be more
suitable for some clients.
Treatment procedure.
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I began by sitting my client down and explained the treatment process in full to ensure she
was comfortable and ok to proceed.
I sanitized my machine and any of the heads that I was using for the treatment.
I used talc as my medium to ensure the G5 heads would move with ease.
I used different heads to suit different body parts.
I used the sponge head, round head, pin head, heavy pronged and egg box.
The round and soft head are equivalent to effleurage. The pin head is used for petrissage.
I was careful to turn on and off the machine under the couch.
I used a medium pressure to suit my clients tolerance.
I started the treatment by using effleurage.
I used the machine at around 40-55 depending on the area being worked on.
I worked over the soleus, gastrocnemius, rectus femoris, biceps femoris, transverse
abdominus, erector spinae and biceps to name a few.
I finished again by using effleurage. I removed the medium using hot towels.
Client Feedback.
My client was very pleased with this treatment. She found it much deeper than manual massage
and enjoyed it thoroughly. She found it a great treatment for warming up the tissues before
starting other treatments.
After/Home Care Advice Given.
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Relax and take it easy for the rest of evening.
Increase water intake to help with the removal of toxins.
Increase exercise routine and get as much fresh air as possible daily.
I gave my client a diet and exercise plan to help her achieve the best results.
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Galvanic.
Next I used the Galvanic on Emer’s problem areas which are her inner thighs and hip area. This
method allows active substances into the skin on a galvanic charge. Saline solution is used on the
pads in order to aid the flow of current. This treatments aims to soften up any areas of fat that
Emer is worried about and it will also disperse the fluid retained in the area. It stimulates nerve
endings in the skin and softens the tissues
 I set the machine on a steady surface, and ensured it was stable before I started the
treatment. I checked all the leads and made sure there was no water near the machine. I
also checked the PATT test to ensure it was safe and in good working order.
 Next I sanitised the machine and the pads attached to it.
 I explained the working principle of the machine to my client, the effects of the machine,
what I am using and doing, and how long the treatment would take so that she felt fully
comfortable before I began the treatment.
 Next I performed a tactile and sensitivity test on my client, first on the face and then the
décolletage. The results were normal.
 I sanitized the area to be treated.
 I applied galvanic anti cellulite gel on to my clients areas of concern which are her thighs and
buttocks area.
 I applied my negative pad (cathode) in a pocket covered in saline solution on to the area
where I applied the gel.
 I applied the positive pad in a pocket opposite to the cathode.
 I applied the cathode to the area where the negative galvanic gel is because liked repel and
they are both negative. Because of this the anti cellulite gel will be pushed down in to the
skin.
 When all the pads were applied and my client was comfortable I began to turn on my
machine.
 I explained to my client that she would feel a mild itchy sensation underneath the pads
which is normal.
 The current is never to exceed 2 milliamps so I needed to pay close attention to the dials
and my client.
 When my client felt comfortable with the dial at 1 milliamp we worked on the negative pole
for 5 minutes.
 When the 5 minutes were up, I turned off the machine and switched the polarity of the
machine to positive for half the length of time of 2 and a half minutes.
 When the treatment was concluded, I rose up my client and gave her aftercare advice.
Client Feedback.
My client was really happy and pleased with the result. She said it took getting used to the itchy
sensation but other than that she really liked the treatment.
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After/Home Care Advice Given.
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Relax and take it easy for the rest of evening.
Increase water intake to help with the removal of toxins.
Increase exercise routine and get as much fresh air as possible daily.
I gave my client a diet and exercise plan to help her achieve the best results.
Avoid and heat treatments.
Microcurrent.
Next I used the The Carlton Professional Microcurrent Machine on my client Emer on her problem
areas which are her upper arms and front of thighs. It uses a modified direct current and is low
intensity. It works on the gogli tendon organ which is present in every muscle. This machine helps
to rejuvenate and recontour muscles using a low intensity direct current. It will work on the gogli
tendon organ by using the same impulse as used by the body to help to keep the muscles toned and
healthy. It is a pleasant, relaxing treatment which speeds up lymphatic drainage thereby removing
toxins in the skin.
I conducted the treatment as follows:
 I set the machine on a steady surface, and ensured it was stable before I started the
treatment. I checked all the leads and made sure there was no water near the machine. I
also checked the PATT test to ensure it was safe and in good working order.
 Next I sanitised the machine and all the instruments with the machine.
 I explained the working principle of the machine to my client, the effects of the machine,
what I am using and doing, and how long the treatment would take so that she felt fully
comfortable before I began the treatment.
 Next I performed a tactile and sensitivity test on my client, first on the face and then the
décolletage. The results were normal.
 I tested the machine on myself to make sure it was in good working order.
 I sanitized the area to be treated.
 I used a mask brush to apply an even layer of microcurrent gel to her skin to allow the
current to be conducted and for easy movement for the microcurrent probes over the skin.
 I switched the machine on to circulation to start warming the tissues firstly.
 I turned up the intensity slowly and moved the probes over her skin for 2-3 minutes to help
increase circulation and warm up the tissues.
 I then switched the machine on to lifting 2 setting .
 I performed grab, glide and slide movements on the biceps and triceps.
 I also performed grab, glide and slide movements over the rectus femoris, Sartorius and
adductors.
 I then turned down the intensity of the machine and kept circling the probes to disperse any
current before removing them from my clients face.
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 I then removed the product from my client’s skin.
 I sat my client up gently and gave her homecare advice.
 This treatment took 20 minutes.
Client Feedback.
My client was really happy and pleased with the result. She found it very relaxing and enjoyed it
thoroughly. I gave her a return appointment.
After/Home Care Advice Given.
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Relax and take it easy for the rest of evening.
Increase water intake to help with the removal of toxins.
Increase exercise routine and get as much fresh air as possible daily.
I gave my client a diet and exercise plan to help her achieve the best results.
Student’s/Therapist’s Signature.........................................
Client’s Signature.................................................................
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Exercise plan.
Squats – great for firm bums and thighs
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perform 2 sets of 15 to 24 repetitions (reps)
Stand with your feet shoulder-width apart and your hands down by your sides or stretched
out in front for extra balance. Lower yourself by bending your knees until they are nearly at
a right angle, with your thighs parallel to the floor. Keep your back straight and don’t let
your knees extend over your toes.
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Lunges – great for firm bums and thighs
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1 set of 15 to 24 reps with each leg
Stand in a split stance with your right leg forward and left leg back. Slowly bend the knees,
lowering into a lunge until both legs are nearly at right angles. Keeping the weight in your
heels, push back up to starting position. Keep your back straight and don’t let your knees
extend over your toes.
Stomach Crunches
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2 sets of 15 to 24 reps
Lie down on your back, knees bent and hands behind your ears. Keeping your lower back
pressed into the floor, raise your shoulder blades no more than 3 inches off the floor and
slowly lower down. Don’t tuck your neck into your chest as you rise and don’t use your
hands to pull your neck up.
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Diet Plan 1500cals
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