Contact Details 


A clear, well presented form with opt-in checkboxes and space for client details.

Opt-in boxes and explanations are included for clarity.

Space included for local emergency contact and General Practitioner or specialist medical professional contact for use in case of emergency.

When a client decides to start working with us, we collect their contact details for invoices, scheduling and practice updates.
In an emergency situations, such as a medical event in session, we may need to share their address with emergency services so we keep all important information on this form for ease of reference.
The form is clear and easy to complete, with opt-in boxes and space for information. All sections are compliant with General Data Protection Regulation (GDPR) requirements.


  • Client Full Name
  • Client Address
  • Client Email and Telephone
  • Emergency Contact Details
  • General Practitioner or Physician
  • Opt-in boxes
  • Explanation of reasons for contact


This document is

  • Collects essential information
  • GDPR Compliant
  • Customisable and editable
  • Updated August 2021

This document is not

  • Is not a Release of Information  
  • It does not give permission to contact a client's doctor except in case of emergencies where confidentiality does not apply

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