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Please note that this medical consultation form will be kept confidential and will only be viewed by the Holistic Practitioner and spa team responsible for you whilst undergoing treatment at this spa and salon. Your details will not be available to third parties and are stored securely.

If any of the answers on this consent form raise concern for your Holistic Practitioner you may be contacted to discuss further or alternatively, these may be discussed at the time of your consultation.

Personal Details

General Health

Are you seeing a doctor or taking any medication at present?

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Massage Policies

Client services and information are confidential. Written authorisation is required from you to release any information.

  • Please turn off your mobile phone for your optimal journey
  • Your scheduled session is set aside for you so please be on time
  • 48 hour cancellation notice is required to avoid being charged on your next appointment
  • You will be draped with towels and at no time will private parts be exposed
  • You will have a chat with your therapist to discuss your session
  • I understand that my massage therapist or I may end the session at any time for any reason
  • Inappropriate behaviour will not be tolerated and may be prosecuted to the full extent of the law

Client Agreement

I acknowledge that massage therapy is not a substitute for medical examination or diagnosis, and it is recommended that a physician be seen for that service.

It is my choice to receive massage as a form of therapy.

I understand that treatment given is designed to address the care and prevention of myofascial pain and dysfunction.

I also understand that at any time I feel pain or discomfort during the session, I will immediately inform my massage therapist so they adjust.

I have stated my pertinent medical conditions, and will update the massage therapist of any changes in my health status.

I understand that my failure to do so may post a threat to my health and/physical well being and I hold harmless Soul Solutions Holistic Spa and my massage therapist from any liability whatsoever arising from failure on my part.

By my electronic signature below, I agree to the massage policy and client agreement above.

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