Client Form 2 – Customer Service Consent Form

Full Name(Required)

Date of Birth(Required)

Address

Street Address City State ZIP Code

Phone Number(Required)

Email Address(Required)

Driver's License Number(Required)

*Driver's License Number needed to verify identity and method of payment. This information will not be used for any other purpose.

Full Name(Required)

Relationship(Required)

Phone Number(Required)

1. Spa and Wellness Treatments

Massage Therapy

Facials and Skincare Treatments

Body Treatments

Aromatherapy

Other Spa Services

2. Health and Wellness Programs:

Yoga and Meditation Sessions

Fitness and Exercise Programs

Nutritional Consultations

Other Wellness Services

Health Information

Please disclose any medical conditions, allergies, or other health concerns that may affect your treatment:

Terms and Conditions

Confidentiality: All personal and medical information provided will be kept confidential and used solely for the purpose of providing the best possible service.
Treatment Risks: I understand that spa and wellness treatments involve certain risks and that I am responsible for informing the therapist/practitioner of any medical conditions or concerns.
Liability Waiver: I release Jardin Secret Spa/Wellness Center and its staff from any liability for any injuries or adverse effects resulting from treatments received.
Cancellation Policy: I acknowledge and agree to the spa's cancellation policy, which requires 24 hours' notice for any cancellations or rescheduling of appointments. Failure to provide sufficient notice may result in a cancellation fee.
Payment: I agree to pay for all services rendered at the time of service unless other arrangements have been made in advance.

Consent and Acknowledgement

By signing below, I acknowledge that I have read and understood the terms and conditions outlined above. I voluntarily consent to the treatments and services provided by Jardin Secret Spa/Wellness Center.

Client e-Signature(Required)

Date(Required)

Parent/Guardian Signature (if under 18)

Date