MASSAGE INTAKE FORM

All services include 10 minutes for dress time / consultation. Its very imortant to arrive early and start appointmnets on time to avoid cutting into your service time.

Client Information
BIRTHDAY
Client Information
How did you hear about Wine & Unwind Day Spa?!
Have you ever experienced a professional massage or bodywork session?
Check your desired modality
Modality Pressure For Massages
Do you want full body massage or focus on specific areas?
If specific area massage, please specify what you would like to focus on.
Choose a beverage of choice, must be 21 years of age or older to consume alcohol, must have ID.
PLEASE SUBMIT AND THEN CONTINUE TO THE WAIVER TO SIGN AND COMPLETE, THANK YOU.





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