• Client Intake Form

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  • Format: (000) 000-0000.
  • Medical History

  • Current Medications

  • Lymphatic Drainage Massage

  • Contraindications for infrared sauna blanket: (Lymphatic wellness experience)

    cardiovascular conditions

    pregnancy 

    recent surgery 

    fever or acute infection 

    impaired ability to sweat

     

    Cupping Therapy Contraindications: (Drain & Detox)

    1. Broken skin
    2. Wounds
    3. Burns
    4. Infections
    5. Rashes
    6. Severe eczema
    7. Bleeding disorders
    8. Blood thinners
    9. Varicose veins
    10. Pregnancy (abdomen and lower back)
    11. Severe heart conditions
    12. High blood pressure
    13. Malignant tumors
    14. Cancer treatment
    15. Severe organ failure (liver, kidney, heart)
    16. Recent surgery
    17. Severe injury
    18. Thin or fragile skin
    19. Fever
    20. Generalized infection

     

  • General Wellness

  • Photo and or Video Consent

  • Consent

  • I, the client mentioned above, hereby consent to receive a lymphatic drainage massage and, if applicable, the use of the infrared sauna blanket. I understand that this therapy is not a substitute for medical care and is provided for relaxation and well-being purposes. I have provided accurate information to the best of my knowledge.

    Please consult with a healthcare professional if you have concerns about participating in lymphatic drainage massage or using the infrared sauna blanket based on your medical history.

  • Termination of session

  • I understand that as a mobile massage therapist, Calma Vida by Helen reserves the right to terminate the massage session or refuse service at any point if she perceives a threat to her safety or experiences inappropriate behavior. In such cases, the session will be ended immediately, and any applicable fees will still apply. I acknowledge the importance of maintaining a safe and professional environment during the massage session.

  • Our policies

  • Our booking policy for all our services are as follows: We utilize the Square Appointments app for both booking and payments.

    Payments are required to be paid in full at the time of booking to secure your appointment. In addition, please note that our team manually reviews and approves all booking requests. In the event that we deny a request, you will not be charged. However, we do not issue refunds for any confirmed bookings. We appreciate your understanding and cooperation in adhering to our policy.

    Your therapist will always arrive 15 minutes early to set up for your appointment =. To ensure that your treatment starts on time, please provide us with detailed instructions such as apartment number, gate codes, name registered with guards, elevator pin, hidden streets, gated community instructions, etc.

    Please make sure to provide a 10 X 10 Space.

    Cancellations

    Please be sure to reschedule appointments 48 hours prior to your scheduled appointment (make sure to read rescheduling policy).

    Cancellations will result in a forfeited session if it's not done before the 48 hour deadline.

    Rescheduling

    You are allowed to reschedule 48 hour prior to your scheduled appointment (No additional charges will be applied the first time, all other will require a rescheduling fee of $50).

    Notices after 48 hours will result in a forfeited session or we may offer you a rescheduling fee of $50 to reschedule your session.

    Refunds

    We absolutely do not offer refunds. All sessions are non refundable. If you need to reschedule please notify us 48 hours prior to your appointment or your forfeit your session.

    By signing below, I confirm that I have read, understood, and agree to abide by the booking, appointment preparation, cancellation, rescheduling, and refund policies set forth by Calma Vida byHelen. *

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