MYOTHERAPY, REMEDIAL MASSAGE & LYMPHATIC DRAINAGE MASSAGE CLINIC

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MANUAL LYMPHATIC DRAINAGE REFERRAL FORM

Please complete the following referral form for patients requiring manual lymphatic drainage. This treatment is beneficial for pre-operative and post-operative care, among other conditions. Ensure all patient information is provided to facilitate an effective consultation and treatment plan.

MYOTHERAPY, REMEDIAL MASSAGE & LYMPHATIC DRAINAGE MASSAGE CLINIC

MANUAL LYMPHATIC DRAINAGE REFERRAL FORM

Patient Information

Medical History and Current Condition

Indications for Manual Lymphatic Drainage

LYMPHATIC DRAINAGE REFERRALS

AUTOIMMUNE CONDITIONS

NEUROLOGICAL AND CEREBROVASCULAR CONDITIONS

DIGESTIVE AND METABOLIC ISSUES

DERMATOLOGICAL CONDITIONS

OTHER CONDITIONS

MYOTHERAPY, REMEDIAL MASSAGE &
LYMPHATIC DRAINAGE MASSAGE CLINIC

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Clinic

Opening Hours