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- Qualifications/ Professional Credentials | ReikiEma
Ema Melanaphy's qualifications, certifications and Professional Credentials as a trusted, accredited expert Holistic Practitioner, Teacher and Wellbeing Professional. Ema Melanaphy's Qualifications & Professional Credentials Ema Melanaphy Founder of ReikiEma Usui Shiki Ryoho & Usui Reiki Ryoho (Reiki, Eastern & Western style methods) Master Teacher Certificate Date of certification: 30/10/2021 Certification from: The Reiki Academy - Torsten Alexander Lange, Reiki Master Teacher, UK Reiki Federation History Ambassador. Professional-level Certificate (alongside Professional Insurance and a Reiki Master Lineage back to Mikao Usui (the founder of Reiki), this qualification entitles a person to teach Reiki courses, to attune people to Usui Reiki at all levels up to and including this level, and to issue certificates and Reiki Master lineages to anyone they attune. Usui Shiki Ryoho (Reiki) Level 2 Reiki Professional Level Date of certification: 10/01/2020 Certification from: Ann Singleton, Reiki Master Teacher, UK Reiki Federation member and CNHC-accredited NOS level 3 Reiki Diploma Course Teacher Professional-level Certificate (alongside Professional Insurance and a Reiki Master Lineage back to Mikao Usui (the founder of Reiki), this qualification entitles a person to begin offering Reiki professionally, in the United Kingdom). Usui Shiki Ryoho: Professional Practitioner Diploma (as verified by the UK Reiki Federation and CNHC) Date of certification: 28/03/2022 Certification from: Ann Singleton (CNHC-approved Diploma Course) Professional-level Diploma Certificate accredited by the UK Reiki Federation as meeting the CNHC's (Complementary Natural Healthcare Council) standards and requirements for Reiki Registrants - including at least 9 months between Reiki level 1 and completion of the course, 10 Case Studies of 4 treatments each, an assessed treatment, answering a series of questions to establish the practitioner understands and can apply the ethical and professional competency requirements of CNHC registrants, and providing Insurance and all Reiki qualification certificates. The CNHC is a voluntary Regulator, and according to the General Medical Council , Medical Professionals in the UK can refer patients to CNHC registrant practitioners. Membership of this register shows a deep commitment to professional standards, ethics and integrated healthcare. It is a marker of trust, and working to meet all the requirements of this qualification took Ema 2 and a half years to attain. Current CNHC Certificate of Registration (originally issued 04/2022) Date of certification: 06/04/2025-6 Certification from: The Complementary and Natural Healthcare Council Registration number: CNHC06607 Current (valid) Certification issued by the Complementary and Natural Healthcare Council. This certifies Ema Melanaphy's status as a currently Registered Reiki Professional Practitioner, and means that Ema is regulated by the CNHC, and appears on their Register (available and searchable online here ). It also authorises Ema Melanaphy to use the CNHC logo in relation to Ema's professional Reiki practice (for humans). UK Reiki Federation - certificate of recognition as an Animal Reiki Professional Practitioner Date of certification: 11/04/2022 Certification from: UK Reiki Federation Reiki for Animals Certificate Date of certification: 17/03/2021 Certification from: Jo Rose, Animal Physical Therapy, Applied Behaviour and Courses Continuous Professional Development certificate having spent one day of in-person training with the teacher, in December 2020, and having completed several Animal Reiki case studies, as well as homework assignments. As a Professional Reiki Practitioner for humans at the time, having been volunteering regularly at the RSPCA offering Reiki to the cats and dogs there, for 9 months at this point, this certificate qualified Ema to add Reiki for Animals to their Professional Insurance, in order to add it to their Professional Services, when the lockdown restrictions ended. Holistic Acupressure Practitioner/Foundation-level Shiatsu Certificate Date of certification: 01/09/2021 Certification from: Shiatsu College (Manchester) When the Reiki Council's Animal Reiki Profession was introduced by the UK Reiki Federation , Ema was one of the earliest Members in North West England to apply for Animal Reiki accreditation. The accreditation requirements were reassuringly rigorous, and involved an application form, competency questions, submission of case studies and sending in in certification and Animal Reiki professional Insurance for verification and validation. As one of their certified Animal Reiki Practitioners, Ema Melanaphy appears on the UK Reiki Federation's Searchable directory for Animal Reiki Practitioners, which you can access here . This certificate was awarded to Ema after completion of the first year of a 3-year Shiatsu Diploma course (which took 2 years, due to the pandemic preventing normal teaching and practice treatments during the lockdowns and Social restriction rules. Ema was the only 1st year student to complete the course requirements and to receive this certificate, in their year group. Completion of the first year of this level 4 (CNHC-accredited) Diploma course enables Ema to offer student-level Shiatsu, and Holistic Acupressure (the certificate awarded for completion of the first year, has since been changed to "Bodywork for Wellbeing" from Holistic Acupressure). This certificate requirement included 50 Shiatsu pratice treatments given, 3 professional Shiatsu treatments received, attendance at 2 full days of training per month (22 days per year), home study and assignments, as well as an Anatomy and Physiology Course, and practical assessments. Pregnancy Massage (including abdominal massage) Diploma Date of certification: 17/04/2023 Certification from: Gateway Workshops Therapeutic Meditation Teacher Certificate Date of certification: 02/12/2020 Certification from: Ann Singleton, Meditation Teacher and Usui Reiki Master Teacher This is Ema's Pregnancy Massage diploma certificate. A face-to-face course, with practical and theory training, and a tutor assessment. "Natural Lift" Facial Rejuvenation Massage Date of certification: 18/08/2024 Certification from: Gateway Workshops This is Ema's Therapeutic Meditation Teacher qualification. The course was carried out remotely with assignments, online live teaching and practice, and a final live practical and case study assessment. Ema is certified to offer 121 and group meditations, as well as recorded therapeutic meditations, in a range of different styles, for different therapeutic and lifestyle/wellbeing requirements. This is Ema's "Natural Lift" Facial massage Practitioner Diploma certificate. A face-to-face course, with practical and theory training, and an in-person practical tutor-assessed treatment. Ema is also DBS Certified, fully professionally insured, and a current UK Reiki Federation member (listed on the UK Reiki Federation website). For further information or if you have any queries, please contact ReikiEma .
- Live Video | ReikiEma
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- Wisdom Keepers Video | ReikiEma
Intuition Development Workshop Online Featuring The Home Healer (Tanvir Anowar) Dowsing Intuition Energetic meditation How to connect with your intuition. Discover your hidden gifts, and develop yourself, to reach your full potential. Wisdom Keepers Video Wisdom Keepers: Connect to the Light Within Watch Preview £ Buy from £ 5 Facebook Twitter Pinterest Tumblr Copy Link Link Copied
- Our Privacy Policy at ReikiEma
Protecting your data is our priority. Learn about the data we collect, how we use it, and your rights. Stay informed with our Privacy Policy. Kaupapahere Tūmataiti Raraunga kohikohi tatou Ka kohia, ka penapenahia e matou nga korero ka kohia aunoa e tenei paetukutuku, me nga korero ka tukuna e koe ma te imeera, puka, tuhinga, waea ranei. Ko nga korero ka tukuna e koe ka whakamahia anake mo te kaupapa i tukuna e koe (hei tauira, ma te whakamahi i to wahitau imeera me to nama waea ki te whakautu ki to karere, ki te whakarite hui ranei mo koe, mena kua tono koe e), mo ReikiEma. Ka kohia hoki e matou te IP (Internet Protocol) wāhitau e whakamahia ana e to rorohiko ki te hono atu ki te ipurangi, rorohiko me nga korero hononga, me te hoko hitori. Ka whakamahi pea matou i nga taputapu tātari hei ine me te kohikohi korero mo to huihuinga i runga i te Reikiema.com , tae atu ki nga wa whakautu wharangi, te roa o te wa e pau ana ki etahi wharangi, nga korero taunekeneke wharangi, me pehea koe e tirotiro haere atu ai i te wharangi. Ka kohia ano e matou nga korero tautuhi (tae atu ki te imeera, te ingoa, nga whakawhitiwhiti korero), nga korero, nga urupare, nga arotake, nga taunakitanga me nga korero whaiaro. Me pehea te whakamahi i o raraunga Kare matou, kare ano hoki e hoko i o raraunga. E kore matou e tohatoha i o raraunga ki tetahi atu whakahaere (mehemea ka hiahiatia e te UK, he ture ture ranei o te ao e pa ana). E kore matou e whakamahi i o raraunga e pa ana ki etahi atu mahi, mahi pakihi ranei, me te kore i whiwhi whakaaetanga tuatahi ki te mahi pera. Ko nga korero ka kohia e matou mo to whakamahi i te paetukutuku ka whakamahia pea ki te ako mo o hiahia hei kaihoko, me te whangai ano ki te mohio ki te mahi me te whai huatanga o te paetukutuku ake, ki te whakapai ake i te uru me te whai hua. Ka kohia e matou enei raraunga whaiaro me te kore-whaiaro, mo nga kaupapa e whai ake nei: Hei whakarato me te whakahaere i nga Ratonga; Ki te whakarato ki a maatau kaiwhakamahi me nga manuhiri ki te awhina i nga kaihoko me te tautoko hangarau; Kia taea ki te whakapā atu ki a tatou manuhiri me nga kaiwhakamahi me nga panui whanui me nga panui e pa ana ki nga ratonga me nga panui whakatairanga; Ki te hanga i nga raraunga tatauranga whakahiato, me etahi atu korero whakahiato/whakaahua kore-whaiaro, ka whakamahia e matou, e o maatau hoa pakihi ki te whakarato me te whakapai ake i a maatau ratonga; Ki te whai i nga ture me nga ture e pa ana. Me pehea e penapena ai o korero Reikiema.com kei runga i te papaaho Wix.com. Ka whakawhiwhia e Wix.com ki a maatau te papaahi ipurangi e taea ai e matou te hoko atu i a maatau ratonga ki a koe. Ka penapenahia o raraunga ma te rokiroki raraunga a Wix.com, nga papaa raraunga me nga tono whanui Wix.com. Ka penapenahia e raatau o raraunga ki runga i nga tūmau haumaru kei muri i te papangaahi. Me pehea me te take ka whakapā atu matou ki a koe Ka whakapā atu pea matou ki a koe ki te whakamohio ki a koe mo o maimoatanga, ki te whakarite arotake mo o maimoatanga, ki te whakatau i tetahi tautohetohe, ki te kohi utu, moni nama ranei, ki te pooti i o whakaaro ma roto i nga rangahau me nga paatai, ki te tuku korero mo to kamupene, ki te kore e tika, ki te whakamana i ta matou Whakaaetanga Kaiwhakamahi, nga ture a te UK e tika ana, me etahi whakaaetanga kei a matou me koe. Mo enei kaupapa ka taea e matou te whakapiri atu ki a koe ma te imeera, waea, karere kuputuhi, me te mēra. Pihikete Ka whakamahi a Wix.com i nga pihikete hiranga me te mahi, kei te rongoa i runga i to rorohiko. Kei te waatea etahi atu korero i runga i ta maatau wharangi Panui Pihikete . Whakaaetanga Mena kei te pirangi koe ki te whakaputa ki waho, ki te tango ranei i to whakaaetanga mo matou ki te kohi, ki te penapena me te whakamahi i o raraunga, penei i runga ake nei, tena koa whakamohio mai ma te imeera, ki: reikiema.therapy@gmail.com , ma te reta ranei, ki: ReikiEma (FAO Ema Melanaphy) Huinga 3, 3-5 Wilson Patten Street Warrington Cheshire WA1 1PG Whakahōu Kaupapahere Tūmataiti Kei a matou te mana ki te whakarereke i tenei kaupapa here tūmataiti i nga wa katoa, na koa tirohia mai i nga wa katoa. Ko nga huringa me nga whakamaramatanga ka whai mana tonu i runga i ta ratou tukunga ki te paetukutuku. Mena ka whakarereketia e matou tenei kaupapa here, ka whakamohio atu matou ki a koe i konei kua whakahouhia, kia mohio ai koe he aha nga korero ka kohia e matou, me pehea te whakamahi, me nga ahuatanga, mehemea he, ka whakamahia e matou, ka whakaatu ranei. te reira. Nga Uiui me nga Tono Whakauru Kaupapa Mena kei te pirangi koe ki te uru atu, ki te whakatika, ki te whakatika, ki te whakakore ranei i etahi o nga korero kei a matou mo koe, me waea mai ki a matou ma te imeera, i runga: reikiema.therapy@gmail.com , ma te reta ranei, ki: ReikiEma (FAO Ema Melanaphy) Huinga 3, 3-5 Wilson Patten Street Warrington Cheshire WA1 1PG Ka tukuna atu e matou he whakautu ki a koe mo to tono ma te tikanga ano i whakapā mai koe ki a matou, me te kore whakaroa, a i roto i te waa 30 ra (i runga i te ture o te UK)
- ReikiEma's Terms of Service. Client Code of Care
Discover our holistic therapist's Client Code of Care & Terms of Service at ReikiEma in Merseyside, Cheshire, Greater Manchester and Lancashire, UK. Prioritise your wellbeing with our transparent terms, and know what you can expect when you book a treatment with us. Referral Programme Kainga Mō Treatments Gift cards & shop Projects Challenges Nga Korero me nga Takahanga Members Search Results Referral Programme More Client Code of Care & Terms of Service Client Code of Care Terms & Conditions of Service You will be treated with care and respect at all times. All information disclosed during your consultation or treatment will remain confidential, unless your permission is granted to share it; with the following exceptions (under which Complementary Therapists are legally and professionally obliged to report to the appropriate authorities): Suspicion of terrorism Suspicion of the abuse of a child Suspicion of someone being in danger (including threat of suicide) If you are receiving treatment for an ongoing medical condition from your GP or hospital, it is recommended to inform all parties concerned, if you are receiving Reiki. Reiki is not a replacement for conventional medical treatment. If you are concerned about a serious or urgent condition, please contact your GP or other appropriate NHS healthcare provider. Ema Melanaphy endorses and abides by the UK Reiki Federation’s Code of Practice for Reiki, and the CNHC’s Code of Conduct. Copies of these documents are available upon request. The Practitioner has fully explained the treatment and procedures involved in Reiki, Shiatsu, Pregnancy Massage, Womb Healing Massage, "Natural Lift" Facial rejuvenation massage and Therapeutic 121 Meditation. I am aware that the Practitioner is qualified to practise student-level Shiatsu as one of the services they offer in their professional practice. I accept the fee payable will be as stated on the website for the service(s) booked, per hour/session/week/month. I accept that at least 3 days notice is required for cancellation or rescheduling of an appointment. If I cancel an appointment between 24 and 48 hours before my booking, a 50% refund will be made. For cancellations on the day of the appointment, the full treatment fee will be payable (unless in exceptional circumstances, at the discretion of the practitioner). I understand that Reiki can involve light touch, or be given as a hands-off treatment. I understand that Footwear and glasses need to be removed for all treatments, other than Meditation. I understand that respect for body privacy will be maintained at all times. I understand that I can choose to stop the treatment at any point. I understand that the Practitioner reserves the right to refuse or postpone treatment if they feel physically unsafe, disrespected or abused, or if the client is under the influence of alcohol or other substances. Book a treatment
- Pregnancy Massage | ReikiEma
Indulge in the soothing mind and body benefits of safe, expert pregnancy massage at ReikiEma Warrington, St Helens, Wigan, and mobile treatments covering the whole North-West. Discover a holistic approach to wellness for expecting Mamas, and their babies too. Ema is an experienced, qualified and insured pregnancy massage practitioner. This is a full-body massage adapted to be safe during pregnancy, but can also be tailored to help support and support individual pregnancy symptoms. Pregnancy Massage Full-body massage, specially adapted for pregnancy, and suitable for aiding in post-partum recovery. This treatment offers a range of Health & Wellbeing benefits; for both Mama-to-be, and baby A gentle, relaxing, health-promoting full-body massage, tailored to support pregnancy, from trimester 2 until childbirth, as well as aiding in postpartum recovery. Massage during pregnancy can alleviate symptoms, help to ease and soothe tightness, pressure on joints, organs and ligaments, and calms stresses. Price and Booking The Benefits of Massage during pregnancy Regular massage during a pregnancy can benefit Mothers, as well as their unborn baby, and supports the Mother emotionally and physiologically - and the endorphins it brings to the Mother are passed to b aby as well. It can help childbirth to be easier, as well as having benefits for postpartum recovery. Some of the benefits of regular massage during pregnancy are: 1. Stimulation of the blood circulation: bringing nutrients and fluids to the organs of the body, and to the baby. 2. Lymphatic drainage: detoxification, eliminating toxins and waste, and reducing oedema (swelling). 3. Promoting healthy digestion; 4. Releasing muscular tension and compression, 5. Helping avoid varicose veins; 6. Inducing deep relaxation and reducing emotional stress; 7. Helping maintain a healthy, balanced blood pressure. Massage also encourages the release of oxytocin , which is a pain reducing hormone - providing pain relief during labour and childbirth. Price and Booking "With the end of my second trimester in a couple of weeks, I wanted to get myself third trimester ready with the summer time bliss package* with Ema - it sounded amazing! It started with a massage which was wonderful and got rid of so much tension, it was tailored to exactly what I needed according to symptoms, pains etc. The reiki going into the guided meditation was lovely and I’ve never felt so relaxed during a treatment. I highly recommend this treatment to anyone who is needing that extra self care and connection in pregnancy. Thank you, Ema." KD, Cheshire * (The "Bliss" pregnancy packages with Ema combine a full Pregnancy Massage, Reiki session, and a guided connection meditation, for mamas-to-be and their little ones. Spending some special quality time together, in a safe, held, energetic space)
- ReikiEma's Payment Plans and holistic treatment bundles.
Discover flexible great deals on holistic treatment bundles in the NW of England. We offer convenient payment plans and great offers at ReikiEma . Ema offers tailored plans and pricing to suit your needs. Plans and Pricing We've plans to suit every budget. Unlock savings and enjoy exclusive extras, by joining one of our plans, today. Are you thinking of gifting a Plan or a treatment bundle? If so, then you'll need an e-gift card ~ as our plans and bundles can't be transferred or shared. E-gift Cards Choose your pricing plan Bundle of Joy: Trimester 2 £ 555 555£ From Trimester 2 through to Post-Partem, let us take care of you and baby's "us time", with weekly pregnancy massages from Trimester 2, onwards. Helping your health, wellbeing, easing symptoms. Valid for 12 months Select Treatment Plan: Mobile Pregnancy Massage 30-day Reiki Challenge phased payments £ 16.66 16.66£ Every month Spread your payments and join in the 30-day Reiki Challenge Valid for 3 months Select 30-day Reiki Challenge Bundle of Joy: Trimester 3 & Postpartem £ 800 800£ Let us support you and your baby, during the last few precious weeks before you meet each other in the wide world. Receive that extra support and comfort, easing you into childbirth and recovery. Valid for 6 months Select Treatment Plan: Mobile Pregnancy Massage Mobile Wellbeing bundle £ 160 160£ Buy a course of sessions and get £5+ off the cost of each Valid for 6 months Select 4 x 1-hour treatments (Mix & Match) 1 wellbeing-boosting meditation download VIP Gold Membership £ 150 150£ Every month Maintain your Zen! Perfect for frequent/regular treatments Valid for 3 months Select Weekly treatments (Reiki or Shiatsu) Advance notice and discounts for events Free access to online recorded meditations 1 free gift voucher to gift a Shiatsu, Reiki or Animal Reiki Agile Membership £ 80 80£ Every month 2 treatments per month. Cancel whenever. Select 2 x Treatments per month Silver Membership £ 85 85£ Every month Perfect for regular/top up treatments Valid for 3 months Select 2 x 1-hour treatments per month Discounts on forthcoming events Gift voucher for 50% off a Reiki, Shiatsu or Animal Reiki. Annual Distance Reiki Pass £ 495 495£ Buy a year of monthly Reiki treatments, and use them at your own convenience: anytime, any place. Valid for one year Select 12 distance Reiki treatments A healing Reiki meditation download of your choice Distance Reiki Bundle of 3 £ 120 120£ 3 hours of distance Reiki treatments, whenever and wherever works for you! Valid for 12 months Select 3 hours of distance Reiki, from Ema 1 guided Reiki meditation download of your choice. Distance Reiki bundle of 5 £ 200 200£ 5 hours of distance Reiki, from Ema. Whenever, wherever! Valid for 12 months Select 5 hours' worth of distance Reiki treatments from Ema 1 guided meditation of your choice, to download Animal Reiki bundle of 3 £ 120 120£ The gift of wellbeing for your companion animal. Valid for 12 months Select 3 x hours of Animal Reiki (distance or mobile sessions) Distance Animal Reiki - bundle of 6 £ 205 205£ 6 hours of Animal Reiki treatments Valid for one year Select 6 hours of distance Animal Reiki treatments 5 session package: Natural Lift Facial £ 225 225£ Optimise and maximise the rejuvenating benefits of our "Natural Lift" Facial Massage treatment Valid for 6 months Select Natural Lift Package Ultimate Uplift Plan £ 140 140£ Every month 12 weekly sessions - for maximum effect facial rejuvenation Valid for 3 months Select The Ultimate Uplift package (x12) In-clinic Wellbeing Bundle £ 180 180£ Pick & Mix from 4 of our most popular clinic treatments, and get £5 off each treatment! Valid for 6 months Select Reiki, Shiatsu, Womb massage, "Natural Lift" facial massage 5 Elements & You £ 1.99 1.99£ Every month Empower yourself with timeless wisdom and knowledge. Bring greater balance, harmony and inner resourcing to your everyday life. Enrich your holistic toolbox with this learning program 7 day free trial Start Free Trial Accessible Online Learning Programs (Automatic Registration) Membership in our Online Community (Automatic Registration)
- Refer a Friend | ReikiEma
https://static.wixstatic.com/media/7cafce_370971e2a0bb42209a67f25a5bf4c7e3%7Emv2.png Reiki Master Teacher Reiki Courses CNHC Reiki practitioner Animal Reiki Natural Lift facial Shiatsu massage Womb massage Pregnancy massage Meditation https://static.wixstatic.com/media/7cafce_1e380e6d99034f7d927697a7920778de~mv2.png Get a £ 5 discount on your session Apply reward when placing your first order. Get My Reward Get a £ 5 discount for each friend you refer Our thank you to you! Share the perks with a friend, when you share the gift of wellbeing! Give your friends a £ 5 discount. Get a £ 5 discount for each friend who books a session. Applies to the lowest priced session in the cart. Log in to refer * Applies to the lowest priced item in the cart.
- ReikiEma Gift Cards
Looking for the perfect gift? Send one of our gift cards for holistic therapy sessions at ReikiEma in Cheshire, Greater Manchester, Lancashire and St. Helens, UK. Give the gift of wellness today! E-gift Cards eGift Card £25 You can't go wrong with a gift card. Choose an amount and write a personalized message to make this gift perfect! Wellbeing treats for everyone - from Reiki to Pregnancy Massage, and Courses. Amount £25 £50 £100 £150 £200 Other amount Quantity Buy Now The gift of Wellbeing: from Reiki to Womb Massage, from Reiki Meditation downloads to Reiki courses. Make someone's day with a thoughtful present that's as unique and special as they are.
- Pregnancy Post-Natal Massage Client Form | ReikiEma
Pregnancy and post-partum Massage New Client online form Pregnancy & Post-Natal Massage Client Form Pregnancy/Post-Natal Massage: Medical & Consent Form * First name * Last name * Date of Birth Day Month Month Year * Address * Phone Email * Emergency Contact: Name & relationship to you * Emergency Contact: Phone number (for us to phone/text) How did you hear about ReikiEma? Google Search Other Website Search Recommendation/Word of Mouth Social Media Other Yes, subscribe me to your newsletter. * Have you received Massage Therapy or Bodywork before (including before pregnancy)? Yes No Medical Details * GP Address * GP Surgery Phone number * Have you received Massage Therapy or any other Complementary or Holistic Therapies before? Past Complementary Therapies/Massage If yes, what type of therapy, and (approximately) when was your last treatment? Other therapies * Are you currently taking any Medication? Yes - prescribed Yes - not prescribed No * If you are taking any medications, please specify the name if you can, and what it's for. Medications info * Do you exercise? Yes No If you answered "yes" to the previous question, how many times per week, for how long, and what type(s) of exercise? Exercise info Please list and briefly describe any conditions or symptoms you have experienced, or are experiencing. * Any allergies or sensitivities * Have you had any serious or chronic illness, operations or traumatic accidents? Serious or chronic illness, surgery or traumatic accidents * Pre-natal Care Provider Pre-natal Care Provider info May I have permission to contact your Care Provider? * Due Date Day Month Month Year * This is my (number: 1st, 2nd etc) Pregnancy Pregnancy Number * This will be my (number: 1st, 2nd...) birth. Birth number * Please tick current problems. Anaemia Leaking Amniotic Fluid, or Vaginal Bleeding * Bladder infection * Uterine bleeding * Blood clot or phlebitis * Chronic hypertension * Abdominal Cramping * Diabetes (gestational or mellitus) Oedema/swelling Fatigue Headaches Insomnia High Blood Pressure * Leg cramps Miscarriage * Heartburn Nausea Problems with placenta * Pre-term labour * Pre-eclampsia (toxemia) * Sciatica Separation of the rectus muscles Separation of the symphysis pubis Skin disorders / athlete's foot Excess thirst Varicose Veins Visual disturbances * Previous caesarian birth Contagious conditions Muscle sprain/strain Heart attack/stroke Constipation Carpal Tunnel Syndrome Low Blood Pressure Morning sickness Anxiety, stress or mood swings Breathlessness Other conditions or problems in current or past pregnancy (please detail below) Anything else you would like me to know? (please detail below) Current pregnancy conditions and symptoms * Please tick any problems experienced in previous pregnancy(ies) Anaemia Leaking Amniotic Fluid, or Vaginal Bleeding Bladder infection Uterine bleeding Blood clot or phlebitis Chronic hypertension Abdominal Cramping Diabetes (gestational or mellitus) Oedema/swelling Fatigue Headaches Insomnia High Blood Pressure Leg cramps Miscarriage Heartburn Nausea Problems with placenta Pre-term labour Pre-eclampsia (toxemia) Sciatica Separation of the rectus muscles Separation of the symphysis pubis Skin disorders / athlete's foot Excess thirst Varicose Veins Visual disturbances Previous caesarian birth Contagious conditions Muscle sprain/strain Heart attack/stroke Constipation Carpal Tunnel Syndrome Low Blood Pressure Morning sickness Anxiety, stress or mood swings Breathlessness Other conditions or problems in current or past pregnancy (please detail below) Anything else you would like me to know? (please detail below) Previous pregnancy conditions and symptoms Further details on current/past pregnancy conditions/symptoms Further details on pregnancy conditions/symptoms I am experiencing a low risk/high risk pregnancy, according to my doctor/midwife. Disclaimer / Client Statement For my records, I need to confirm that you have read, understood and answered all of the previous questions. If there is anything you do not understand, or wish to ask about, please ask me now (before signing this statement). Otherwise, please read the following statement, and sign below to show that you agree. To the best of my knowledge, the information I have given in this form is true, and I have not withheld any information concerning my health. I will keep Ema Melanaphy updated on my health, should there be any changes to the answers already given. If I have, or develop any medical complications (marked with * in the list above) I will discuss the condition with my massage therapist, and will get a medical release signed by my pre-natal care provider, before continuing bodywork. * Client Signature Drawing mode selected. Drawing requires a mouse or touchpad. For keyboard accessibility, select Type or Upload. Date Day Month Month Year Submit







