Privacy of personal information is an important principle to Essentials Deluxe Day Spa. We are committed to collecting, using, and disclosing personal information responsibly and only to the extent necessary for the goods and services we provide.

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Essentials Deluxe Day Spa

1525 30th Avenue North, Saint Petersburg, FL 33704


Review Essentials Deluxe Day Spa Privacy Policy

PLEASE SIGN THAT YOU HAVE READ AND UNDERSTAND THE FOLLOWING POLICIES:

Late Arrivals: Arriving Late may deprive you of treatment time. 

Cancellation Policy: If you are unable to keep a scheduled appointment, please give 3 HOURS advanced notice to ensure that you will not be charged for it. Voicemail messaging is available for your convience after hours. If less than 24 hours notice is given and we are unable to fill your time slot, you will be expected to pay a cancellation fee of 25.00 and you will be expected to either prepay for future appointments or put a card on file to be charged for any future cancellation fees. 

Refunds: There will be no refunds for goods, services, or gift cards.

Medical: For your protection, please inform us of any medical conditions that may require our attention/affect your treament. In the event your health history changes, please notify us and complete a new client intake form.

Notifications: Consent to recieve emails and SMS text messages.

 

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 the practitioner so that the pressure may be adjusted to my level of comfort. I further understand that a massage therapist (LMT) neither diagnoses illness, disease or any other medical, physical or mental disorder, nor performs any spinal manipulations. I am responsible for consulting a qualified physician for any ailment that I have because an LMT must be aware of any changes to my physical health. I understand that there shall be no liability on the practitioners part or Essentials Deluxe Day Spa should I fail to do so. I also understand that Essentials Deluxe Day Spa reserves the right to refuse service to anyone and that any sexually suggestive remarks or advances made by myself will result in immediate termintaion of the session, and I will be liable for payment of the scheduled appointment.

Client Signature: 

Please select who will be receiving the service...
AdultMinor
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First Clients Name

First Name*

Middle Name

Last Name*

Phone*
First Clients Date of Birth*
First Clients Information
How did you hear about us? *
Event
Flyer
Friend/Family
Internet
Other Location
Other
Sign
Valpak
For Females: Are you Pregnant?*
No
Yes
If so, what trimester? *
1st
2nd
3rd
Not Pregnant

Do you or have you had any allergies,major health issues, injuries, or surgeries?

Please list ANY medications you are currently taking:
First Clients Signature*
Clients Address
Address Line 1:*
Street address, P.O. box, company name, c/o
Address Line 2:
Apartment, suite, unit, building, floor, etc.
Country:*
City:*
State/Province:*
Zip/Postal:*
Parent or Guardian's Email Address

Email
Check to receive information, news, and discounts by e-mail.
A signed copy of this waiver will be sent to the email address you provide.
Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Middle Name

Last Name*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Information
How did you hear about us? *
Event
Flyer
Friend/Family
Internet
Other Location
Other
Sign
Valpak
For Females: Are you Pregnant?*
No
Yes
If so, what trimester? *
1st
2nd
3rd
Not Pregnant

Do you or have you had any allergies,major health issues, injuries, or surgeries?

Please list ANY medications you are currently taking:
Parent or Guardian's Signature*
Electronic Signature Consent*
By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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