Method of Diagnosis by Interview | Traditional Thai Massage Association Japan（TTMA）：NPO

Method of Diagnosis by Interview

■Diagnosis by asking questions
When perform a Thai ancient rite massage, it is very important that I clarify the physical condition of the client in the meaning to prevent an accident. I carried below counseling sheet for basic diagnosis by asking questions. This is an introduction part of the questions and I accept the situation from each question and ask about some more, and it is important at first to understand the physical condition of the client properly.

A counseling sheet sample
Please answer the following questions in what the surgical operation will refer to.

１、Do you sleep well every day?

Yes No

２、Have you had anything to eat in the last hour?

Yes No

３、Ｔhe eating habits are regular one.

Yes No

４、Do you feel physical fatigue?

Yes No

５、Do you feel psychic fatigue?

Yes No

６、Do you often sit for long time at the same possition?

Yes No

７、Do you often driving a car?

Yes No

８、Do you exercise every day?

Yes No

９、Do you experience chronic stiffness in your shoulder?

Yes No

１０、Do you have problems with elimination?

Yes No

１１、How many hours do you sleep per day?

（　　　）Time degree

１２、Do you have high or low blood pressure?

Yes No

（　　/　　） mmHg

１３、Are you sickor do you have any injuuries at the moment?.

Yes No

If yes,what kind?

（　　　　）

１４、Have you had any critical illness in the pasy?

Yes No

If yes,what kind?

（　　　　）

１５、Have you had an operation or broken any bones in the last 6months?

Yes No

１６、Are you regularly seeing a doctor?

Yes No

１７、Are you taking any medicine?

Yes No

If yes,waht kind?

（　　　　）

１８、Do you have any allergies?

Yes No

If yes,waht kind?

（　　　　）

１９、How often do you have a massage?

Yes No

Average（　　）/month

２０、What massage do you prefer?

Yes No

strong/medium/gentl

２１、Do you have pain the following day after a massage?

Yes No

If yes,where?

（　　　　）

２２、Have you had skin problems?

Yes No

What kind?（　　　　）

２３、Have a habit of smoking

Yes No

２４、(the women)Cramps is a storong one.

Yes No

２５、(the woman)Do you have your period?

Yes No

２６、Do you have any pain now?Please check where

Stiffness in the shoulders,Stiffness in the back,Pain the chest,Sensitivity to the cold,Swelling of the legs,Pain in the thighs,Plain in the stomach,Swelling of the face,Stiffness in the neck,Lumbago,Eyestrain,Legache,Pain in the claves,Pain in the bottom,Pain in the upper arms,Headache,Dizzy.

２７、Please notice us if you have would to care physical part.

２８、Is there the item to apply to as follows?

High fever,Get drunk,Gout,Rheumatism,Heart trouble,Hernia,Osteoporosis,Epidemic,Cerebrovascular accident,Brain tumor,Disease of the gynecology system.