PERFORMANCE TASK IN HILOT WELLNESS MASSAGE

Name: _____________________________________ Grade & Section: _____________________

Instruction: Interview at least 3 person assuming that they will undergo hilot wellness massage. Fill in
the data needed in the form provided. Disregard the data on vital signs.

Name: Age: Address:

Gender: Amount of pressure: __ light __ medium ___ hard

Vital Signs CHECK IF YOU HAVE THE FOLLOWING CONDITIONS:

Temperature:
Pulse Rate: YES NO
Respiratory Rate: 1. Diabetes
Blood Pressure: 2. Allergic Reactions
3. Skin irritation
4. Recent Surgery
5. Pregnancy
6. High blood pressure
7. Pins and plates inserted in
your bone
8. Cancer