New Client Profile

Name *
Name
Phone *
Phone
Address
Address
Date of Birth
Date of Birth
Spa Policy Acknowledgement *

New Massage Client Profile and Consent

Name *
Name
If you are currently pregnant, please use our Prenatal Massage Client Form.
Reason for scheduling a massage today: *
Health Conditions *
Please check all that apply.
Policy Acknowledgement *
I have read and agree to Spa One Eighty's Policies.
I have completed this form to the best of my knowledge. I understand that massage therapy services are a therapeutic health aid and do not take the place of a physician's care. I verify that the information given regarding my known physical conditions, medical conditions, and medications is correct to the best of my knowledge, and I will inform Spa One Eighty of any changes.
Date *
Date