Kings Cross & Hampsteadachillesclinic.co.uk · 07897 732158Achilles Clinic · New client intakeNew Client Intake FormSimon, a few details help Alexander prepare for your first appointment. Answer what you can, leave the rest blank, and we can go through anything in person.ClientSimonTreatmentThe Blueprint Assessment · 60 minAppointmentThursday, 12 November 2026 at 10:00ClinicKings Cross, LondonFormNew client intake01What brings you in?In your own words. There is no right answer, and you can add detail at the appointment.What would you most like help with? *Where is the main area? (optional)When did it start? (optional)A rough answer is fine, for example 'about six weeks ago' or 'after a run in March'.What tends to make it worse, and what eases it? (optional)How is it affecting your usual activity? (optional)02Relevant health historyOnly what relates to your treatment. Share what you are comfortable sharing; we can cover the rest in person.Is there any health information you think may be relevant to your treatment?NoYesNot sureIf yes or not sure, please tell us (optional)Current medication or allergies (optional)Anything relevant to hands-on treatment, such as blood thinners or skin reactions.Previous injury, surgery, treatment or scans (optional)03Your goalsWhat would you like to be able to do again?What would you like to get back to? (optional)Anything else you would like Alexander to know? (optional)How your answers are handledThese answers are health information. They are stored securely and seen only by Alexander and clinic staff, to prepare for and keep a record of your treatment. They are not used for marketing. Read how we handle data in our privacy notice.You can discuss or update anything at your appointment, and you can ask us to correct or delete these answers at any time.Send my answersOnly your reason for attending is required. Everything else can wait until we meet.
