NVQB20 – Provide Body Massage

Therapist Name / Date
VTCT Number / Portfolio number
Client Name / Assessment / Yes / No
BMLO11 i
Male / Female New/ Existing
(past records checked) / Standard / Summative / Formative
BMLO5 a,h,i,o
BMLO6 c,h,i
Health & Safety check
 Sterilised tools
 Hands sanitised
 Area free from obstruction
 Adequate temperature
 Adequate lighting
 Adequate ventilation
 Materials disposed of in accordance to H & S regulations
 Electrics checked
Products dispensed correctly
Follow professional Ethics / BMLO7 c,j
General contra indication
May prevent full service
 Bacterial infection
 Viral infection
 Fungal infection
 Parasitic infection
Heart condition
 Diabetes
 Cancer
 High/low BP
 Undiagnosed lumps
 Loss of skin sensation
 Deep Vein Thrombosis (DVT)
 Epilepsy
 Rheumatism / BMLO7 c,j
Local contra indications
Service requiring adaption
 Recent scar tissue
 Recent operation
 Psoriasis
 Eczema
Temporary contra indications
Service may require adaption
 Medication
 Bruising
 Skin abrasions
 Oedema
 During Chemo/Radio therapy
 Product allergies
 Pregnancy
BMLO7 d,e,l,m BMLO12 a
Lifestyle Question and Analysis (Questioning)
Any medical history which may restrict or prohibit the service application?
Indicate any modification of treatment, or reasons why treatment could not be carried out:
Currently taking any medication which may affect the appearance of the skin or skin sensitivity?
Current dietary plan
Current fluid intake
Current Stress levels 1-4
BMLO5 k
Pre treatment indemnity signature; information is correct at time of treatment:
Current exercise habits
Smoker?
Description of sleep patterns
BMLO2 oTreatment objectives
 Relaxation  Sense of well being  Uplifting  Anti-cellulite  Stimulating
Treatment Areas
 Face  Scalp
 Chest & Shoulders  Arms & hands
 Abdomen  Back
 Gluteals  Legs & Feet
BMLO5 m
Service Times:
 75 mins  60 mins  30 mins / BMLO7 g,h
Physical Characteristics(Visual)
 Mesomorph
 Endomorph
 Ectomorph
 Posture checked
 Posture abnormalities present? ______
 skin type checked
BMLO8 c BMLO11 c,m,
Products Used (Manual)
Sanitiser  Massage oil
 Massage cream  Powder / BMLO6 j BMLO11 a,b,d,h,j,k,l,m
Equipment Used
Consumables  Audio sonic
 Infra red  Gyratory massager G5
BMLO7 f BMLO12 b,c,d
After Care Advice
 Recommended time intervals between services
 Importance of a course of service to improve the skin condition.
 Modification of lifestyle patterns
 Healthy eating and exercise advice / BMLO11 f,g
Massage Techniques
 Effleurage
 Petrissage
 Tapotement
 Vibrations
 Frictions
Retail Opportunities
 Products suitable to use at home
 Progression of service plan
 New product or service offered to the client
Client Evaluation e.g. polite, professional, capable. Explanation of treatment good/not enough. Please feel free to put any comments down about the salon, therapist and treatments to enable us to provide a good service. Thank you.
Client Signature Date
BMLO11 o
Therapist self evaluation
The technique I can do well is:
I feel I need to improve on:
The products I recommended were:
This is because:
Did they buy the recommended product? Yes/ No
I encourage my client to rebook for:
This is because:
Did they rebook with you? Yes/ No
Therapist Signature Date
Assessor Feedback
Oral questions asked relating to:
 H & S  C.I’s  Routine Products  Home care  C.A’s  Consultation
Assessor Signature Date