Have you ever been diagnosed with or received treatment for any of the following conditions? Please check all that apply.
Heart disease or high blood pressure
Diabetes
Respiratory conditions
Circulation problems
Neurological conditions
Autoimmune disorders
Cancer
Skin disorders or infections
Digestive disorders
Musculoskeletal conditions
Mental health conditions (e.g., anxiety, depression)
Other (Please specify):
Please provide any additional details regarding the checked conditions, such as current treatment, medication usage, or relevant medical history. Declaration: I hereby declare that all of the information provided above is accurate and complete, to the best of my knowledge. I understand that it is my responsibility to inform the reflexologist of any changes to my health status.
