<p> Clients’ TESTIMONIAL of Craniosacral Therapy </p><p>PART A 1. Please tick those conditions that you have attended a Craniosacral Therapy (CST) treatment session for:</p><p>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</p><p>Secretary Address: Elaine Goggin, Bawnmore, Kilmallock, Co. Limerick 2. Are craniosacral therapists you know, members of IACST (Irish Association Of Craniosacral Therapists Ltd)? </p><p>Yes  No  I don’t know </p><p>3. Are therapists you know, who are treating babies, qualified in Paediatrics? </p><p>Yes  No  I don’t know </p><p>4. Please outline your experience of craniosacral therapy and why you chose this therapy:</p><p>5. Please add any other comments that you feel may be beneficial:</p><p>6. Would you like the IACST to respond to any queries you may have given in your feedback?</p><p>Yes  No</p><p>7. Parent of Child/Client: </p><p>8. Name: (Optional)</p><p>9. Tel: (Optional)</p><p> www.iacst.ie [email protected] 086 2111146</p><p>Secretary Address: Elaine Goggin, Bawnmore, Kilmallock, Co. Limerick PART B</p><p>1) How many treatments of craniosacral therapy did you have?</p><p>0-2  3-5  5+ </p><p>Yes  No </p><p>2) Did you seek treatment for a specific condition?</p><p>Condition cleared  Slight improvement  Significant improvement  Not at all  Improvement </p><p>3) If yes to 2a, how much did your condition improve? </p><p>4) Of what duration were your treatment session(s)? 0-30 mins  31-59 mins  60+ mins </p><p>5) How much did each of your treatment sessions cost? €0-30  €50-79  €31-49  €80+ </p><p>6) In which county did you receive your treatment? ______</p><p>7) How did you hear about craniosacral therapy / who may have referred you? Family/Friend  GP/Physio/other health professional  Internet  Noticeboard </p><p>Other (please specify) ______</p><p>8) How satisfied were you with your therapist's explanations and answers to your questions? www.iacst.ie [email protected] 086 2111146</p><p>Secretary Address: Elaine Goggin, Bawnmore, Kilmallock, Co. Limerick Totally satisfied  Somewhat satisfied  Very satisfied  Not at all satisfied  Satisfied </p><p>Excellent  Poor  Good  Very poor  Average  9) How would you rate your craniosacral therapist's professionalism?</p><p>Totally satisfied  Somewhat satisfied  Very satisfied  Not at all satisfied  Satisfied  10) How satisfied were you with the treatment location?</p><p>Thank you!</p><p> www.iacst.ie [email protected] 086 2111146</p><p>Secretary Address: Elaine Goggin, Bawnmore, Kilmallock, Co. Limerick</p>