All persons under the age of 18 are required to have a parent or legal guardian fill out this form (unless legally emancipated).
By signing below you agree that you are the parent or legal guardian of the minor receiving treatment(s) at Anjou Spa. You will also be required, if needed, to assist the minor in preparing for his/her treatment(s). For children 15 years of age or younger, a parent or legal guardian must be present in the room at the time of service. The minor will be paired with a therapist of the same gender.
You agree that you have completed the Intake Form and have informed the therapist of any and all medical diagnoses, symptoms, medications, and complaints associated with the minor receiving treatment(s). You also agree that you are financially responsible for the minor and that you must schedule all appointments on their behalf.