Reflexology Session Note (Seated/Chair)

Session Header

Date/Time: [Session date; start–end time or duration in minutes]

Setting: [Venue type or event name]; [private room / semi-private / open area]

Practitioner: [Name], [Credential(s)]

Client: [Name]; [DOB or contact] (If declined, state: "Limited identifiers per event model; client declined additional contact details.")

Consent & Intake

• Consent: [written / electronic / verbal] obtained; client confirms understanding that service is not medical diagnosis or treatment and they may stop or modify at any time. (If not obtained or incomplete, document explicitly with reason.)
• Pressure preference: [light / moderate / firm]; Areas to avoid: [specific areas / none reported / client declined to answer]
• Client-stated goal: [1–2 sentence summary; may include brief quote]
• Contraindication screening: [No precautions identified / Precautions identified / Screening incomplete or declined] (Screened for injury to treatment areas, skin integrity, circulatory/neurologic concerns, pregnancy if relevant. If precautions identified, specify findings and planned modifications.)
• Prior sessions: [First visit / Returning] (If returning, note any reported reactions since last session or health status changes.)

Service Delivered

• Positioning: [Seated posture]; Footwear: [on / off / socks on]; Supports used: [as applicable]; Client limitations: [describe / none]
• Areas treated: [Feet / Hands / Ears]; Laterality: [left / right / bilateral]; Regions: [anatomic regions addressed] (If reflexology map focus areas are referenced, label as "Reflexology map emphasis" without implying disease treatment.)
• Techniques: [Methods used]; Pressure: [light / moderate / firm], [maintained / adjusted as tolerated]; Time: [minutes per area or overall]
• Modifications: [Describe deviations due to screening findings or tolerance / None required]
• Hygiene: Hand hygiene performed. Gloves: [not indicated / indicated and used: reason]

Response

• Tolerance: [Tolerated well / Needed reduced pressure / Requested early stop / Session ended early: reason]
• Client-reported immediate response: [Client reports…] (Use direct attribution.)
• Practitioner-observed signs: [Relevant observations] (Document only what was directly observed.)
• Practitioner impression: [1–2 sentence synthesis on whether goal was met and notable tenderness or guarding patterns] (Do not diagnose or imply treatment of illness.)

Adverse Event

(Only include this subsection if an adverse event occurred.)

• Time of onset: [Timestamp or relative time]
• Signs/symptoms: [Observed signs]; Client reports: "[quote]"
• Immediate actions taken: [Actions within scope]
• Disposition: [Recovered on site / Declined further care / Referred to on-site medical / EMS transport]
• Notifications: [Parties notified / None]
• Follow-up plan: [Plan and timeframe, if applicable]

Plan

• Post-session education: [Guidance provided: hydration, rest, expected transient responses within 24 hours] (Framed as education, not medical direction. If aftercare not reviewed, document reason.)
• Follow-up: [As desired / PRN / Suggested timeframe]
• Red-flag guidance: [If concerning signs observed, document recommendation given and client verbalized understanding] (Only include if applicable.)

Authentication

[Practitioner signature or initials], [Credential(s)] — [Date/time of documentation]

[Standard entry / Late entry / Addendum] (If late entry or addendum, state reason.)