Spa Consultation Form
Spa Consultation Form
Please fill out this form to help us tailor your spa treatments to your specific needs and preferences.
Personal Information
Name
Phone number
Date of Birth
Do you have any allergies?
e.g., skin, scent, food
If yes, please specify:
Are you currently taking any medications?
If yes, please specify:
Do you have any chronic conditions?
If yes, please specify:
What are your primary concerns or goals for today's treatment?
e.g., relaxation, pain relief, skincare
Have you received any of the following treatments before?
Check all that apply.
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Swedish Massage
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Deep Tissue Massage
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Hot Stone Massage
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Aromatherapy Treatment
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Facials
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Body Wraps/Scrubs
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Manicure/Pedicure
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Waxing
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Reflexology
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What is your skin type?
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Oily
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Dry
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Combination
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Sensitive
Do you have any specific skincare concerns?
If yes, please explain:
Consent
By signing this form, you confirm that the information provided is accurate and give consent for the treatments discussed.
Name:
Date:
