Focus 4 Massage

Left Side of Neck

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Right Side of Neck

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Left Side of Upper Back

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Right Side of Upper Back

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Left Side of Mid Back

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Right Side of Mid Back

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Left Side of Low Back

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Right Side of Low Back

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Chest

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Abdomen

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Left Shoulder

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Right Shoulder

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Left Elbow

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Right Elbow

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Left Wrist

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Right Wrist

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Left Hand

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Right Hand

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Left Hip

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Right Hip

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Right Knee

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Right Ankle

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Left Foot

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Right Foot

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Left Arm

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Left Knee

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Left Leg

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Right Leg

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Right Arm

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Left Ankle

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Chronic Daily Headache

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Cluster

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Headaches

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Migraines

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Rebound

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Sinus

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Tension

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Anemia

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Bleeding Disorder

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Haemophilia

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Hepatitis

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High Cholesterol

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HIV

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HIV/AIDS

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Hypercoagulability

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Polycythemia

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Thrombosis/Embolism

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Acute Coronary Syndrome

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Aneurysm

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Angina

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Atherosclerosis

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Blood Clots

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Blood Pressure

High or Low

Cardiac Arrhythmia

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Cardiovascular Accident

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Cardiovascular Conditions

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Chronic Ischemic Heart Disease

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Chronic Venous Insufficiency

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Cold Feet

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Cold Hands

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Congenital Heart Defect

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Congestive Heart Failure

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Coronary Artery Disease

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Heart Attack

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Heart Disease

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High Blood Pressure

High or Low

Hyperlipidemia

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Low Blood Pressure

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Lymphedema

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Myocardial infarction

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Pacemaker

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Pericarditis

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Phlebitis

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Raynaud Disease

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Rheumatic Heart Disease

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Valve Disorders

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Varicose Veins

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Acute Pancreatitis

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Diabetes

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Hyperthyroidism

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Hypothyroidism

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Pituitary and Growth Disorder

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Prostate Condition

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Arthritis

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Cardiovascular

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Respiratory

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Celiac Disease

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Constipation

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Crohn's Disease

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Diarrhea

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Digestive Conditions

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Diverticulitis

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Eating Disorder

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Esophageal Disorder

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Fecal Impaction

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Intestinal Polyps

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Irritable Bowel Syndrome

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Poor Appetite

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Stomach Disorder

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Ulcerative Colitis

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Conductive Hearing Loss

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Ear Problems

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Hearing Loss

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Meniere Disease

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Motion Sickness

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Tinnitus

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Vertigo

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Allergies

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Anaphylaxis

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Cancer

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Hodgkin Lymphoma

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Infectious Mononucleosis

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Leukemia

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Lupus

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Non-Hodgkin Lymphoma

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Rheumatoid Arthritis

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Bladder Disorder

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Chronic Kidney Disease

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Congenital Kidney Disease

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Electrolyte Imbalance

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Kidney Stones

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Renal Cysts

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Urinary Incontinence

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Urinary Tract Infection

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Amyotrophic Lateral Sclerosis (ALS)

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Ankylosing Spondylitis

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Arthritis

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Artificial Joints / Special Equipment

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Bone Disease

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Compartment Syndrome

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Dislocation

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Fibromyalgia

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Fracture

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Gout

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Hereditary/Congenital Deformity

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Jaw Pain (TMJD)

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Joint Injury

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Muscular Dystrophy

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Myasthenia Gravis

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Osgood-Schlatter Disease

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Osteoarthritis

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Osteomalacia

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Osteoporosis

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Paget Disease

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Psoriatic Arthritis

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Scleroderma

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Scoliosis

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Sinus Problems

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Strain/Sprain

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Tendonitis/Bursitis

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Brain Disorder

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Brain Injury

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Burning

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Cerebral Palsy

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Cerebral Vascular Accident (Stroke)

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Cerebral-vascular Accident

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Chronic Pain Disorder

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Dizziness

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Epilepsy

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Herniated Disc

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Huntington Disease

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Loss of Sensation

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Multiple Sclerosis

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Numbness

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Parkinsons

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Sciatic Pain

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Seizure Disorder

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Shingles

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Stabbing

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Stroke

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Tingling

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Transient Ischemic Attacks (TIA)

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Vertebral and Spinal Cord Injury

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Breast Disorder

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Ectopic Pregnancy

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Endometriosis

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Gynaecological Conditions

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Menopause

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Menstrual Cycle Disorder

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Ovarian Cysts/Tumors

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Pelvic Inflammatory Disease

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Pregnancy

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Premenstrual Syndrome

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Uterine Disorder

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Asthma

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Bronchitis

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Chronic Cough

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COPD

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Cystic Fibrosis

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Emphysema

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Infectious Respiratory Conditions

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Respiratory Conditions

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Respiratory Tract Infection

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Shortness of Breath

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Tuberculosis

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Acne

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Allergic Dermatosis

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Athlete's Foot

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Athletes Foot

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Bruise Easily

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Chemical Burn

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Herpes

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Hypersensitive Reaction

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Hypersensitive Reactions

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Infectious Skin Conditions

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Melanoma

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Melanoma/Carcinoma

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Pigmentary Disorder

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Plantar's Wart

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Psoriasis

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Rash

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Rosacea

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Skin Conditions

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Skin Irritations

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UV Burn

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Insomnia

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Mental Illness

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Surgical Pins or Wire

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Vision Loss

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Vision Problems

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Other Medical Conditions

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Other Diagnosed Diseases

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Patient Intake Form

Personal Information

Emergency Contact Information

Doctor Information

Conditions

Area of Complaint

Headaches

Blood

Cardiovascular

Endocrine

Family History

Gastrointestinal

Hearing

Immune

Kidney

Musculoskeletal

Neurological

Reproductive

Respiratory

Skin

Miscellaneous

Additional Information

Patient Summary