Oasis Massage and Spa- Massage Form
The following is for our records only. We will not sell or give out your information.
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Full Name: *
Mobile Number: *
Email: *
Address (including zip code) : *
Date of Birth: *
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Emergency Contact Name and Number: *
Occupation:
How would you like to receive appointment reminders? *
How did you hear about Oasis?
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Please mark all areas of pain:
Mark all Health conditions:
If pregnant, how many weeks?
Please mark any areas you would like avoided during your massage:
Statement of Understanding
I understand that massage therapy is for the well-being of the body and mind. Our licensed massage therapists do not diagnose illness, or any physical or mental disorder, nor do they prescribe any medical treatment. To better the results of my massage, I have fully completed the above information to the best of my knowledge. Also, as a client, my health information will be utilized only by my therapists. I understand that massage therapy is not intended for sexual purposes. At any time throughout the massage if either I or my therapist should feel uncomfortable, the appointment can be immediately terminated. Oasis Massage and Spa reserves the right to refuse service to any client for any reason; clients who appear to be under the influence of drugs and/or alcohol, will be turned away for their own safety and to protect the integrity of our service providers and their license.
Date acknowledging the Statement of Understanding: *
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