Let's start with you

A few minutes. Your answers stay between you and Body Dream Massage, and are used only to prepare your treatment safely.

First and last name

How should we address you?

Ms. Mr. No preference

Your email We send you a copy of this form.

Your mobile number We confirm appointments by text.

How old are you?

What is your postal code? It is used to work out travel. The full address is asked for at booking.

The treatment

If you are unsure, choose the last option. Your technician will advise you.

Which treatment interests you?

Post-operative lymphatic drainage I'm preparing for upcoming surgery Body contouring, wood therapy or cellulite treatment Body scrub, dry brushing, infratherapy or infrared facial Therapeutic massage (Swedish, deep tissue or relaxation) I do not know yet, I would like advice

Your surgery

Where are you with surgery?

I had surgery in the last 12 months My surgery is coming up soon No surgery

Surgery details

Body Dream Massage removes no drains, no stitches, and does no wound care and no injections. Those belong to your medical team. These questions are here to adapt the pressure and the areas worked on.

Which surgery did you have? Tick everything that applies.

Date of surgery An approximate date is enough.

In which country?

Do you still have drains?

Yes No I do not know

Do you still have stitches?

Yes No I do not know

Have you had a complication since? Tick everything that applies.

Has your surgeon cleared you to receive massage?

Yes No I do not know I have no follow-up with my surgeon

Are you wearing a compression garment (faja)?

Yes No I do not know

Which areas were operated on? Tick everything that applies.

Have you ever had dizziness or fainting spells? Drainage can lower your blood pressure.

Yes, before surgery Yes, since surgery No I do not know

Do you drink at least 1.5 litres of water a day?

Yes No I do not know

Have you smoked or drunk alcohol since the surgery?

Yes No I would rather not say

Your surgeon's name

How many drainage sessions have you already had?

Your upcoming surgery

Body Dream Massage performs no medical acts, before or after the operation. These questions are here to prepare the follow-up and to hold the right time slots once the surgery is behind you.

Which surgery is planned? Tick everything that applies.

Planned date of surgery An approximate date is enough.

In which country?

Your surgeon's name

Which areas will be operated on? Tick everything that applies.

Have you had cosmetic surgery before this one?

Yes No

Have you ever had dizziness or fainting spells? Drainage can lower your blood pressure.

Yes No I do not know

Do you drink at least 1.5 litres of water a day?

Yes No I do not know

Do you smoke or drink alcohol?

Yes No I would rather not say

Do you already have your compression garment (faja)?

Yes No I do not know

The area to work on

Which area would you like worked on? Tick everything that applies.

Have you had this type of treatment before?

Yes No

Have you had any of these treatments in the area to be worked on?

Your skin

These three questions help us choose the pressure, the heat and the products.

What is your skin type? Six tones, from the palest to the deepest. Choose the description closest to you.

Very pale skin, always burns, never tans Pale skin, burns easily, tans a little Light to medium skin, sometimes burns, tans gradually Olive or light brown skin, rarely burns, tans easily Brown skin, very rarely burns, tans deeply Deep brown to black skin, almost never burns I do not know

Do you get keloids or thick scars? A keloid is a scar that grows and spreads beyond the wound.

Yes No I do not know

Does your skin keep dark marks after a spot or an injury?

Yes No I do not know

Your health

Last health section. The final three questions are optional.

Do you have any of these conditions? Tick everything that applies.

Are you pregnant or breastfeeding?

Yes, pregnant Yes, breastfeeding No I would rather not say

Which medications do you take? Write « none » if there are none. Do mention blood thinners and weight-loss injections such as Ozempic or Wegovy.

Do you have any allergies? Oils, creams, latex, fragrances.

Is there anything else we should know?

Signature

Four confirmations, your name, and it is done.

How your information is handled

Body Dream Massage collects this information only to prepare and give your treatment safely. It is kept in Google Sheets, on servers located outside Québec, including in the United States. Only the Body Dream Massage team has access to it. It is kept for 7 years after your last treatment, then deleted. You may ask to see it, correct it or have it deleted by writing to pamela@bodydream.ca. Person responsible for the protection of personal information: Pamela Calix.

Cancellation policy

$85 deposit at booking. Cancelled more than 48 h ahead: deposit refunded in full. Between 48 h and 24 h: half the deposit is kept. Less than 24 h ahead, or no-show: the whole deposit is kept.

Your confirmations I confirm that my answers are accurate. I understand that Body Dream Massage performs no medical acts. No drain removal, no stitch removal, no wound care, no injections, no diagnosis. I agree that my information may be collected and kept as described above. I have read the cancellation policy.

Sign by writing your full name Your name, the date and the time are recorded together. This signature has the same value as a handwritten one.

How did you hear about us?

We have it

Body Dream Massage will write to you within 24 hours to set the time. A copy of your answers has just been sent to your email.