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Ive Sedentary Last Visit to the Doctor: GP Address: No. of Children (if applicable): Date of Last Period (if applicable): Client Name: Address: Profession: Tel. No: Day Eve 30 40 40 50 50 60 60+ CONTRAINDICATIONS (select if/where appropriate): Never treat unless the injury has been diagnosed and treatment has been recommended by a medical practitioner Asthma Pregnancy Cardio vascular conditions (thrombosis, Any dysfunction of the nervous system (e.g. phlebitis, hypertension, hypotens.

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