Clients TESTIMONIAL of Craniosacral Therapy
Total Page：16
File Type：pdf, Size：1020Kb
Clients’ TESTIMONIAL of Craniosacral Therapy
PART A 1. Please tick those conditions that you have attended a Craniosacral Therapy (CST) treatment session for:
ADD Attention deficit disorder / ADHD Learning difficulties Allergies Menstrual pain/PMT Anxiety Neck pain Arthritis Post Traumatic stress disorder Autistic spectrum disorder Panic attacks Asthma Post surgery Back pain Postnatal depression Behavioral problems Problems with suck in infants Bells palsy Pre and post frenectomy (tongue tie) Colic Plagiocephally/misshapen head Cerebral palsy Positional discomfort while feeding/car transporting/bathing and sleeping – in babies Chronic fatigue Reflux or prolonged colic Chest infections Road traffic accident (RTA) Constipation Reflexes – delayed Depression Sciatica Dizziness Speech difficulties Digestive system conditions Scoliosis/ADD spinal curvatures Dyslexia/Dyspraxia Sinusitis/Nasal congestion Developmental conditions Sleeping difficulties Ear infections Squint Feeding problems in babies Seizures Fibromyalgia Stress related conditions Frozen shoulder Tinnitus Headaches Trauma Hyperactivity Tantrums Hormonal imbalances Teeth problems Immune system conditions Torticollis Insomnia Traumatic and difficult births including C- Section, Forceps and Vacuum delivery Infant sleeping difficulties Trigeminal neuralgia Irritable bowel syndrome (IBS) Vertigo Joint problems Whiplash www.iacst.ie [email protected] 086 2111146
Secretary Address: Elaine Goggin, Bawnmore, Kilmallock, Co. Limerick 2. Are craniosacral therapists you know, members of IACST (Irish Association Of Craniosacral Therapists Ltd)?
Yes No I don’t know
3. Are therapists you know, who are treating babies, qualified in Paediatrics?
Yes No I don’t know
4. Please outline your experience of craniosacral therapy and why you chose this therapy:
5. Please add any other comments that you feel may be beneficial:
6. Would you like the IACST to respond to any queries you may have given in your feedback?
Yes No
7. Parent of Child/Client:
8. Name: (Optional)
9. Tel: (Optional)
www.iacst.ie [email protected] 086 2111146
Secretary Address: Elaine Goggin, Bawnmore, Kilmallock, Co. Limerick PART B
1) How many treatments of craniosacral therapy did you have?
0-2 3-5 5+
Yes No
2) Did you seek treatment for a specific condition?
Condition cleared Slight improvement Significant improvement Not at all Improvement
3) If yes to 2a, how much did your condition improve?
4) Of what duration were your treatment session(s)? 0-30 mins 31-59 mins 60+ mins
5) How much did each of your treatment sessions cost? €0-30 €50-79 €31-49 €80+
6) In which county did you receive your treatment? ______
7) How did you hear about craniosacral therapy / who may have referred you? Family/Friend GP/Physio/other health professional Internet Noticeboard
Other (please specify) ______
8) How satisfied were you with your therapist's explanations and answers to your questions? www.iacst.ie [email protected] 086 2111146
Secretary Address: Elaine Goggin, Bawnmore, Kilmallock, Co. Limerick Totally satisfied Somewhat satisfied Very satisfied Not at all satisfied Satisfied
Excellent Poor Good Very poor Average 9) How would you rate your craniosacral therapist's professionalism?
Totally satisfied Somewhat satisfied Very satisfied Not at all satisfied Satisfied 10) How satisfied were you with the treatment location?
Thank you!
www.iacst.ie [email protected] 086 2111146
Secretary Address: Elaine Goggin, Bawnmore, Kilmallock, Co. Limerick