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  • MOCEE DAY SPA CLIENT INTAKE FORM

  • Thank you for signing up MoCee Day Spa client intake form. We highly respect and value your privacy. Therefore, we will duly and diligently safeguard and protect the privacy and confidentiality of your personal details. - the question with (* ) is a required field.

  • The following information will be used to help plan safe and effective massage sessions. Please answer the questions to the best of your knowledge

  • Pls Note: Clients under the age of 17 must be accompanied by a parent or legal guardian!

  • ACKNOWLEDGE & CONSENT:

    In order to serve you better, please read the information below:

  • 1) I give my permission to receive massage therapy.

    2) I understand that therapeutic massage is not a substitute for traditional medical treatment or medications.

    3) I understand that the massage therapist does not diagnose illnesses or injuries, or prescribe medications.

    4) I acknowledge that it is my sole responsibility to secure any and all medical clearances to receive massage therapy.

    5) I understand the risks associated with massage therapy include, but are not limited to:
    • Superficial bruising
    • Short-term muscle soreness
    • Exacerbation of undiscovered injury
    I therefore release the company and the individual massage therapist from all liability concerning these injuries that may occur during the massage session.

    6) I understand the importance of informing my massage therapist of all medical conditions and medications I am taking, and to let the massage therapist know about any changes to these. I understand that there may be additional risks based on my physical condition.

    7) I understand that it is my responsibility to inform my massage therapist of any discomfort I may feel during the massage session so he/she may adjust accordingly.

    8) I understand this is professional business with a strict policy prohibiting harassment of employee or unlawful solicitation.

    9) I acknowledge that I have sufficient understanding of massage therapy, and I have been adequately informed and provided sufficient opportunity to ask questions. I hereby give my informed consent to receive massage therapy service.

    10) I understand that I or the massage therapist may terminate the session at any time.

    11). We strive for excellence! Your satisfaction is our priority. If you have any concern or comment please contact our store manager at mgr.mocee@yahoo.com or ask for manager at the counter.

  • By typing your name below (First & Last name) you are digitally signing MoCee Day Spa's Client Intake Form: