Skin Deep Day Spa, LLC
1216 Wildwood, Suite C, Jackson, MI 49202
517.990.9088 - skindeepspajackson.com
Please complete this form thoroughly and answer the questions honestly.
Please discuss massage type options &/or the blending of pressures (light in some areas/heavier in others) with your massage therapist at the time of your appointment.
Our Celluma device offers pain relief with zero physical contact by low level light therapy. We can add the Celluma light therapy to your service upon request.
Epilepsy & Celluma Low Level Light Therapy - LED light therapy is not recomended for those with epilepsy.
Claustrophobia & Celluma Low Level Light Therapy -Depending on where the light therapy is needed, for example over the face for anti-aging, acne, or for pain mangament, one who suffers from claustrophobia may wish to see the device prior to scheduling a service.
Claustrophobia & Body Rituals - Our Body Rituals sometimes include a full body wrap, where your body is cocooned in warm blankets for a few minutes while our deep moisturizing cream soaks in and nourishes your skin. One who suffers from claustrophobia may find this uncomfortable.
Please Note: It is our policy that we do not offer any services to persons that are less than 12 weeks into their pregnancy. We request you set your appointment for a date after the initial 12 weeks of your pregnancy has passed.
By signing this form, I hereby release, hold harmless, waive, discharge, and covenant not to sue Skin Deep Day Spa, LLC, its directors, oﬃcers, employees, volunteers, and agents with respect to any liability for any injury, loss, and/or damage (including, but not limited to, illness or death) that I may sustain related to services &/or treatments rendered. I further hereby knowingly consent to receive treatment from Skin Deep Day Spa, LLC