Le tadalafil possède une affinité marquée pour la PDE5, mais épargne en grande partie les isoformes PDE1, PDE2 et PDE11, réduisant ainsi le risque d’effets extra-caverneux. L’action se traduit par une augmentation contrôlée de la circulation sanguine locale, indépendante des variations alimentaires. Sa pharmacocinétique repose sur une absorption digestive rapide, un métabolisme hépatique par CYP3A4 et une distribution tissulaire large. La biodisponibilité reste stable, et l’équilibre plasmatique est atteint en quelques jours lors d’administrations répétées. Les interactions cliniquement significatives surviennent avec les inhibiteurs puissants de CYP3A4 tels que le kétoconazole. Dans la littérature pharmacologique, acheter cialis 20 mg est souvent associé à des schémas d’utilisation basés sur la durée prolongée de son action.

Microsoft word - health information sheet.doc

CLIENT HEALTH INFORMATION SHEET
PERSONAL DATA:
Name: ________________________________ Date: ______________________________
Birthday: ______________________________ Phone (home):_______________________
Address: _______________________________ Phone (cell): ________________________
City/State/Zip: ________________________________________________________________
Primary Health Care Provider: _____________________ Phone: ______________________
Permission to consult with primary provider? _______ Yes _______ No
Who referred you to this office? __________________________________________________
Advertisement: _______ Sign: _______ Other: _______
MASSAGE HISTORY/TREATMENT INFORMATION
* Have you ever received a professional massage? _____ Yes _____ No
* Preferred massage treatment product. ____ Lotion ____ Oil ____ Aromatherapy
* What are your intentions/expectations for this visit? __________________________
______________________________________________________________________
* What type of pressure do you prefer? _____ Light _____ Medium _____ Deep
* Please check the areas of your body that you give permission to receive massage:
__ Back __ Legs __ Arms __ Neck __ Head __ Face __ Buttocks __ Abdomen
CURRENT MAJOR COMPLAINT INFORMATION
(If you do not have current health concerns, please go to health history section)
* Present symptoms: What is your major complaint or condition that you want to improve?
______________________________________________________________
_______________________________________________________________________
* When did you first notice major complaints? _________________________________
* What activities aggravate the condition? ____________________________________
* What activities alleviate the condition? _____________________________________
* Is this condition getting progressively worse? _____ Yes _____ No
Please explain __________________________________________________________
* Does this condition interfere with:
Work? ___ Yes ___ No Sleep? ___ Yes ___ No Daily routine? ___Yes ___ No
Please explain: _________________________________________________________
* What have you done to get relief? __________________________________________
* Has there been a medical diagnosis? ___ Yes ___ No
If so, by whom? ________________________________________________________
Please explain __________________________________________________________
HEALTH HISTORY
* Are you now under medical/therapeutic treatment? ___ Yes ___ No
If yes, for what condition? _______________________________________________
* List any medications (including aspirin) and nutritional supplements you are taking:
______________________________________________________________________
* List stress reduction and exercise activities. Include frequency: _________________
______________________________________________________________________
* Please list (date and description) any accidents or operations: ___________________
______________________________________________________________________
MUSCULO-SKELETAL SKIN
___ Bone or joint disease ______________________ ___ Allergies __________________
___ Tendonitis ______________________________ ___ Rashes ____________________
___ Bursitis ________________________________ ___ Athlete’s foot _______________
___ Broken/fractured bones ____________________ ___ Warts ____________________
___ Arthritis ________________________________ ___ Other _____________________
___ Sprains/strains ___________________________
___ Low back,hip,leg pain _____________________ DIGESTIVE
___ Neck,shoulder,arm pain ____________________ ___ Constipation
___ Headaches/head injuries ___________________ ___ Gas/bloating
___ Spasms/cramps __________________________ ___ Diverticulitis
___ Jaw pain/ TMJ ___________________________ ___ Irritable bowel syndrome ____
___ Lupus _________________________________ ___ Other _____________________
___ Other __________________________________

CIRCULATORY NERVOUS SYSTEM
___ Heart condition __________________________ ___ Herpes/shingles ____________
___ Varicose veins ___________________________ ___ Numbness/tingling __________
___ Blood clots _____________________________ ___ Chronic pain _______________
___ High blood pressure ______________________ ___ Fatigue ___________________
___ Low blood pressure ______________________ ___ Sleep disorders _____________
___ Lymphedema ___________________________ ___ Other
___ Breathing difficulty _______________________
___ Sinus problems __________________________ REPRODUCTIVE
___ Allergies _______________________________ ___ Pregnant? Stage ____________
___ Other __________________________________ ___ PMS _____________________
AUTO IMMUNE/INFECTIOUS DISEASE OTHER
___ Fibromyalgia ___________________________ ___ Cancer/tumors _____________
___ Chronic fatigue _________________________ ___ Diabetes __________________
___ Rheumatoid arthritis _____________________ ___ Eating disorders ____________
___ Lupus ________________________________ ___ Depression ________________
___ Epstien Barr ____________________________ ___ Drug/alcohol addiction _______
___ Other _________________________________ ___ Nicotine/caffeine addiction ____
It is my choice to receive massage treatment. I realize that the treatment is being given for the
well-being of my body and mind. This includes stress reduction, relief from muscular tension,
spasm or pain, or for increasing circulation or energy flow. I agree to communicate with my
practitioner any time that I feel like my well-being is being compromised.
I understand that massage practitioners do not diagnose illness, disease or any physical or mental
disorder; nor do they prescribe medical treatment, pharmaceuticals, or perform spinal thrust
manipulations. I acknowledge that massage is not a substitute for medical examination or
diagnosis, and that it is recommended that I see a primary health care provider for that service.
I have stated all medical conditions that I am aware of and will update the massage practitioner
of any changes in my health.
Signature: ____________________________________ Date: _______________________

Source: http://www.teamapproach.biz/wp-content/uploads/2011/10/Health-Information-Sheet1.pdf

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