Manifique Appointment Form

Appointment Form
Client Information
Name*

First NameLast Name
Phone Number*

Area CodePhone Number
Email*
example@example.com
Please select the spa services you are interested in

MassageFacialSpray tanWaxingBody Scrub and Massage
Massage options

Full Body 90 minFull body 60 minDeep Tissue 60 minLymphatic Drainage 60 minBack, Neck and Shoulders 30 minsLegs 30 mins
Waxing Options

Pecs and AbsBack, Neck and ShouldersFull LegBCSBCS maintenanceUnderarmsManzillianManzillian maintenanceSpeedo lineButtocksOther - the therapist will be in contact to discuss
What type of waxing treatment would you like?
Spray Tan options

Full bodyFull body maintenance
Facial options

Revitalising 60 minExpress 30 min
15 min appointment
30 min appointment
45 min Appointment
60 min appointment
90 min appointment
Are you a new client

YesNo
Any Allergies?
If yes, please advise.
Medical Conditions or Concerns
If yes, please advise.
For additional information please read www.manifique.co.nz
Should be Empty:

Appointment Form