The Spa Sofia Spa Intake Form

The Spa Sofia
General Information
Name*

First NameLast Name
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Email Address*
example@example.com
Birth Date*

MonthDayYear
Date
Room Guest Last Name (if different)
Room No. (hotel guest only)
Health Information
YesNo
If you are taking medication that you may need during your session please let us know how we can support you below.
YesNo
Weeks 1-12Weeks 13-26Weeks 27-40
Important: If you or any persons for whom you are purchasing massage services (including any package that includes massage therapy), are currently pregnant, only the Feathered Nest massage therapy is appropriate. Please adjust your reservation/purchase if necessary.
Massage Preferences

Your therapist will use their expertise to offer you the most beneficial service possible. Please do not “suffer silently”. If you are too cold, too hot, unable to relax due to the music, if the pressure is too deep or too light, if you want us to move away from a certain area, or anything else…please let us know right away. We are here for you and welcome your feedback!
YesNo
Please list any essential oils you’d prefer we include during your session.
Please list any essential oils you’d prefer we exclude during your session.
LightMediumFirm
Please indicate any areas of discomfort by drawing an "x" in the relevant areas below. (Use a stylus or your finger)
Is there any additional information you’d like to share regarding your session today so that we may serve you well?
Consent

By signing below, I acknowledge that I am aware of the benefits and risks of massage therapy and spa services. My therapist, The Sofia Hotel, and any/all associates will remain free from liability. I understand that it is my choice to receive spa services today and I accept all liability in doing so.
Date*

MonthDayYear
Date
Client's Signature*
Should be Empty:

The Spa Sofia

General Information

Health Information

Massage Preferences

Consent