Hijama consent form 2025

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The document is a medical history form for Hijama Cupping Therapy, requiring personal information, medical history, and lifestyle details from the client. It includes sections on emergency contacts, medical conditions, medications, and contraindications for treatment. The form emphasizes the importance of consulting a physician before undergoing therapy and outlines the client's consent to the procedures involved.

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Click ‘Get Form’ to open the hijama consent form in the editor.
Begin by entering your full name, date of birth, and contact information in the designated fields. This ensures that your practitioner has accurate details for your treatment.
Fill out your medical history, including any special disabilities or needs. Be thorough to help your practitioner understand your health background.
Indicate any medical conditions you may have by checking the appropriate boxes. This section is crucial for ensuring safe treatment.
In the emergency contact section, provide a name and phone number of someone who can be reached if necessary during your treatment.
Review the consent statement at the end of the form carefully. Sign and date it to confirm your understanding and agreement to proceed with hijama therapy.

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