Client Onboarding &

Health Declaration Form

PERSONAL DETAILS

Given Name

Surname

Email

Contact

Date of birth

Day

Month

Year

Gender

Occupation

Emergency Contact Name

Emergency Contact Number

MEDICAL HISTORY & CONTRAINDICATIONS

if you selected any, please explain and indicate how long you have had this condition:

LIFESTYLE

Do you exercise regularly?

Yes

No

Nature of work

Sitting long hours

Standing long hours

Physical labour

Other

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TREATMENT CONSENT

I understand that hands-on therapy may involve temporary soreness or discomfort. I will inform the therapist immediately if I feel pain during treatment. I understand results vary and this is not a medical diagnosis.

I have read and agree to the treatment consent above

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LIABILITY WAIVER

I understand that The Recovery Lab Pte Ltd’.s services are not a substitute for medical diagnosis or treatment. I confirm all information provided is true and complete. I take full responsibility for my personal health condition. I release The Recovery Lab Pte Ltd., its staff and practitioners from any liability related to my treatment.

I agree to the liability waiver terms

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PDPA CONSENT

By submitting this form, I consent to The Recovery Lab Pte Ltd. collecting, using, and storing my personal data for scheduling, treatment, billing and follow-up communication in accordance with Singapore’s PDPA guidelines.

I agree to receive appointment reminders

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PHOTO / VIDEO CONSENT

Photos/Videos

I allow The Recovery Lab Pte Ltd. to use my photos/videos for social media and marketing

I do not allow my photos/videos to be used

Your identity will be handled respectfully. You may withdraw consent anytime.

___________________________________________________________________

SIGNATURE

Signature

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