MASSAGE INTAKE FORM

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?
WOULD YOU LIKE TO ADD SUGAR SCRUB FOR $10? CHECK YES OR NO!
Choose a beverage of choice, must be 21 years of age or older to consume alcohol, must have ID.
If specific area massage, please specify what you would like to focus on.
Is there ANYTHING you do NOT want massaged? Example: FACE, FEET, HEAD, ETC.
WOULD YOU BE INTERESTED IN THE USE OF CBD PRODUCTS DURING YOUR MASSAGE - NO THC ADDED / WE WILL USE ISOLATE (COMING SOON)
PLEASE SUBMIT AND THEN CONTINUE TO THE WAIVER TO SIGN AND COMPLETE, THANK YOU.





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