Record Form

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Examination of tense and weakened muscles
Expiry date
  • Spiral Stabilization Single Session will expire after 1 month from the date of purchase
  • Spiral Stabilization 5 Session Package will expire after 6 months from the date of purchase
Cancellation policy

All appointments must be cancelled within 24 hours of the client’s booked session. In any other case, the session will be charged and deducted from the remainder of the client’s package. Package fees are non-refundable.

Medical disclaimer

The Spiral Stabilization method is not a substitution for medical advice. Prescribed medication can only cease to be taken with approval of your medical practitioner. During a consultation and future follow up sessions no diagnoses will be given and no guarantee to cure will be made.

Please consult your doctor before undertaking any exercise program. Performing Spiral Stabilization exercises without a therapist is at your own risk. Spiral Stabilization Ltd will not be responsible or liable for an injury or harm you sustain as a result of following our exercise videos or information on our website, live streaming on social media, online group sessions, online individual sessions, online courses, online training and education and all other Spiral Stabilization Ltd services.

The information I have given about my general health in this consultation is true to the best of my knowledge and belief, and I hereby give my consent to myself/my child being treated by the practitioner.

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Private and confidential

I explicitly agree to you creating and storing medical records concerning my treatment which may include details concerning my medication, treatment and other issues affecting my health conditions, in accordance with the General Data Protection Regulation (UK GDPR) 2018. I understand that these records will be retained for 6 years (or until I reach 25 in the case of someone aged 16-18), when treatment is ceased in order to comply with insurance guidelines. By signing this declaration you understand that I have to keep your records by law for a period of not less than 6 years, even if you are no longer a client. At this point the records are destroyed by shredding/deletion to protect you and I have made provision in my will that in the event of my death, all records will be shredded/destroyed by my executor in line with the Code of Professional Conduct and Ethics of my professional association.

The reason the data in this consultation record form is collected is so that I can treat you safely and effectively as a complementary therapist who is a member of Complementary Health Professionals.

You can request a copy of all of the information I record on you at any time.

I do not share your personal data with any third party and all information collected is stored in a locked cabinet/secure server and is marked private and confidential.

If you wish to withdraw consent to me contacting you with special offers, appointments, newsletters etc., please do so in writing by emailing me at [email protected].

I have read and understood the above information and give my explicit agreement.

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(conditions, operations, MRI, X-ray, medication, occupation, lifestyle)

Trainer Details