Indian Head Massage
Please read through the questions below, no need to fill it out. Only let me know if you answer Yes to any of the questions or have any concerns. Thank-you.
1 . Are you allergic/sensitive to any of the following? Nuts-almond oil, olive oil, sesame oil, or any essential oils?
| Yes No I’m not sure |
| If “Yes” please specify |
2. Are you pregnant, have epilepsy, asthma or diabetes?
| Yes No I’m not sure |
| If “Yes” please specify |
3. Have you had any recent head or neck injuries?
| Yes No |
| If “Yes” please explain |
4. Are you currently experiencing heart problems?
| Yes No |
| If “Yes” please explain |
5. Have you had recent heart surgery, a stroke or currently have a pacemaker?
| Yes No |
6. Have you dyed your hair in the last 3-4 days or are you planning on dying your hair in the next 3-4 days? Hair dye stays longer if you have a head massage 4 days- 1 week after dying your hair as opposed to 3-4 days before. 1 week after is optimal.
| Yes No |