spa intake form

Client Wellness and Treatment Consent Form

Instructions for Use

• Complete all sections of this form accurately, ensuring that all medical history and contact information is current.
• Review the terms and conditions provided in the operative clauses before signing to ensure you understand your rights and obligations.
• Submit the signed and dated document to the front desk staff prior to the commencement of your scheduled service.

Parties & Definitions

This agreement is entered into by and between [Full Legal Name] ("Client") and [Company Name] ("Service Provider"), located at [Facility Address].

Operative Clauses

1. Medical Disclosure: Client warrants that they have disclosed all known medical conditions, allergies, injuries, or physical limitations. Client agrees to update the Service Provider of any changes to their health status prior to any future treatments.
2. Assumption of Risk: Client acknowledges that wellness treatments involve physical contact and inherent risks. Client voluntarily assumes full responsibility for any risks, injuries, or damages, known or unknown, which might occur as a result of participating in services.
3. Cancellation Policy: Cancellations must be made at least [Number] hours in advance. Failure to provide timely notice will result in a cancellation fee of [Currency Amount].
4. Consent to Treatment: Client grants permission to the assigned therapist to perform the selected services. Client understands that they may stop or modify any treatment at any time for any reason.
5. Privacy and Data Protection: Service Provider agrees to maintain the confidentiality of all personal and medical information provided herein, in accordance with applicable privacy laws and internal data security protocols.
6. Limitation of Liability: To the fullest extent permitted by law, Service Provider shall not be liable for any indirect, incidental, or consequential damages arising from the services provided, except in cases of gross negligence or willful misconduct.
7. Personal Property: Service Provider is not responsible for the loss, theft, or damage of any personal property brought onto the premises. Please ensure all valuables are secured.

Signature & Acknowledgment

I have read, understood, and voluntarily signed this document. I attest that the information provided is true and accurate to the best of my knowledge.

Signature: __________ Printed Name: [Full Legal Name] Title (if applicable): [Job Title] Date: [Date]

Legal Disclaimer: This document is a general framework and does not constitute formal legal advice. Consult with qualified legal counsel to ensure compliance with your specific jurisdiction's health, safety, and privacy regulations.