Spa Intake Form

I understand that massage and holistic treatments are for general wellness purposes, stress reduction, relief from muscular tension, and increasing circulation. I also understand a massage therapist / holistic practitioner must be informed of existing physical conditions. I have stated all my known medical conditions and I understand that it is my responsibility to keep my massage therapist / holistic practitioner informed of any changes in my health and any medication I may begin to take in the future. There shall be no liability on the part of the therapist, The Stable Spa or The Horse Shoe Farm if I fail to do so.

I understand that a massage therapist / holistic practitioner does NOT diagnose illness, disease, or any other physical or mental disorder. As such, a massage therapist / holistic practitioner does NOT prescribe medical treatment or pharmaceuticals and does not perform spinal manipulations. It is clear to me that my massage / holistic treatment session is not a substitute for medical examinations and/or diagnosis, and I understand that I should see a doctor or other appropriate health care provider for diagnosis and treatment of any suspected health problem.

I understand that if I am under the age of 18, that I need to be accompanied by a parent and that a parent’s signature is needed for the treatment to take place.

I understand that I will always be modestly draped, and that the massage / holistic treatment session is non-sexual. I understand that any sexual advances, references, and/or innuendos will not be tolerated. Should any of these be made I understand that I will be asked to pay for the session,