Please read and sign that you understand and agree with the following policies:
CANCELLATION & LATE ARRIVALS
If it is necessary to change your appointment, we request you do so a mininum of 3 hours in advance for an individual appointment or 48 hours in advance for a spa party of 2 people or more. This time is especially reserved just for you and if the appointment is not cancelled, we are not able to offer the time to another guest. Regretfully, if we do not receive the adequate notice of cancellation, $25 cancellation or a no show fee will be charged to the card on file for each service scheduled. If there is no card on file, the full amount of the missed service will be collected before another appointment can be scheduled. We regret that late arrival for your appointment may deprive you of valuable treatment time.
I understand that the massage I receive is provided for the basic purpose of relaxation and relief of muscular tension. If I experience any discomfort during this session, I will immediately inform my Practitioner so that the pressure may be adjusted to my level of comfort. I further understand that a Massage Therapist can neither diagnose illness, disease or any other medical, physical, or mental disorder; nor perform any spinal manipulations. I am responsible for consulting a qualified physican for any ailment that I have. Because a Massage Therapist must be aware of any change in my physical health, I understand that there shall be no liability on the Massage Therapist part or Sage Wellness Spa, should I fail to do so. I also understand that any sexually suggestive remarks or advances made by me will result in immediate termination of the session, and I will be liable for payment of the scheduled appointment.
I hereby acknowledge that I have been provided this notice that the massage service to be received will be provided by Massage Therapists who are independent contractors. I acknowledge that such independent contractors are not employees of Sage Wellness Spa. Therefore, liability, if any, that may arise from the massage service is limited as provided by law. I hereby certify that I am the individual receiving the massage service or a person who is authorized to give consent for the massage service recipient.
RELEASE OF MEDICAL RECORDS
I authorize the release of medical records or other health care information, including intake forms, chart notes, reports, correspondence, billing statements, and other written information to my attorneys, health care providers, and insurance case managers, for the purposes of processing my claims.
I knowingly and willingly consent to have massage therapy during the COVID-19 pandemic. I understand that close contact with people increases the risk of infection from COVID-19. I understand that the COVID-19 virus can have a long incubation period, during which carriers of the virus may not show symptoms and can still be highly contagious. I confirm that I am not presenting any of the following symptoms of COVID-19 listed below:
- Fever temperature over 99.6 F degrees
- Chills with or without body aches
- Shortness of breath
- New loss of sense or taste or smell
- Unexplained sores on soles of feet
- Unsual fatigue
- Sore throat
Please seek immediate attention if you are displaying any severe signs of COVID-19. I confirm that I have not been in close contact with anyone exhibiting the above COVID-19 symptoms within the past 14 days. I further confirm that I am not currently living with anyone who is sick or who is quarantined. To prevent the spread of contagious viruses and to help protect each other, I understand that I will have to follow the massage therapist's guidelines. I also understand that my name and contact information might be shared with the State Health Department in the event that a client or practitioner at this facility tests positive for COVID-19. My contact details will only be shared in the event they are relevant based on suspected exposure date, and only for appropriate follow-up by the Health Department.
Many of our clients ask us about appropriate tipping for their services. We hope you find this information helpful. Sage Wellness Spa fee structure for services allows us to provide you with a spa experience for a reasonable cost. We intentionally keep our fees at a lower cost to allow you to properly "tip" your therapist and/or esthetician. Your expression of gratitude is a significant contribution to the income of our therapists and estheticians. An amount of $10-$40 based on the quality and duration of your service is the customary expression of appreciation for the services provided to you.
Today's Date: January 16, 2021