ClassPass

Name*

First NameLast Name

Phone Number*

Please enter a valid phone number.

Email*

example@example.com

Date of Birth*

Date

Preferred Pronouns? (this helps me address every walk of life accordingly without unintentionally offending anyone)*

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Emergency Contact Name*

First NameLast Name

Emergency Contact Phone Number*

Please enter a valid phone number.

Relationship to Emergency Contact*

Do you have any of the following conditions? (check all that apply)*

Are you taking any medication?*

YesNo

If yes, please list them

I understand that not stating a serious contagious condition is unethical and prohibited. If a contagious condition is noticed or discovered during my session, I acknowledge that the session will be terminated immediately and I will be charged the full price.*

Yes, I understand.

What is your occupation? (This helps me understand your day to day life and movements)*

Do you have any areas of pain, discomfort, mobility restrictions, or tension? (explain)*

When was your last massage?*

Do you have any NEW (6 weeks or less) piercings, tattoos or cosmetic modifications (any fillers, botox, lipo, etc.)*

YesNo

If yes, please list below.

Do you have any sensitivities to scents, lotions, or oils?*

YesNo

If yes, please explain.

Would you like to add any enhancements to your session?*

Area to focus?*

Select Preferred Music (please read section 11 of the terms and conditions below)*

Are there any additional concerns or goals you have for our session?

This policy applies ONLY to clients booking through ClassPass

1. Booking & Payment

All ClassPass appointments must be reserved exclusively through the ClassPass app or website. "Walk-ins” are not accepted.
Services are covered by ClassPass credits only.
No additional booking fees or deposits are required or accepted for ClassPass reservations.
ClassPass reservations apply to the base service only. Substitutions, upgrades, or time extensions are not included unless purchased separately.

1B. Multiple Bookings

ClassPass bookings are limited to one client per appointment.
Couples or back-to-back sessions must be booked separately and are not guaranteed through ClassPass.

1C. Right to Refuse Service (Including Third-Party Bookings)

Chosen Massage and Wellness reserve the right to refuse service to any client, at any time, for any reason deemed necessary by the business owner. This includes, but is not limited to, repeated miscommunication, inappropriate behavior, violation of booking policies, harassment, excessive cancellations or rescheduling, or failure to adhere to posted terms and conditions.

This policy applies to ALL clients, regardless of how the service was booked or purchased—including third-party users. If service is refused:

• All scheduled appointments will be canceled.

• Future booking attempts will be automatically declined and blocked.

1D. Add-Ons & Upsells

Add-on services (hot stones, cupping, CBD oil, foot scrub, aromatherapy upgrades, etc.) are available for purchase at checkout or in person.
Add-ons are paid out-of-pocket and are not covered by ClassPass credits.
Add-ons are subject to availability and time constraints.
All payments are final. Payments must be successfully processed before services are rendered. Chargebacks or disputes against legitimate transactions will result in a permanent ban from booking. Any disputed charge that is ruled in favor of Chosen Massage and Wellness will result in additional legal and administrative fees.

2. Cancellations & No-Shows

ClassPass clients must follow ClassPass’s cancellation and no-show policy as displayed at the time of booking.
Late cancellations or missed appointments are handled directly by ClassPass.
Chosen Massage and Wellness will receive the applicable ClassPass payout for missed services.
No additional cancellation or no-show fees will be charged by the business.
Repeated actions such as late cancellations or no-shows may result in future reservations taking longer to process or restricted access to certain classes or appointments, as determined by ClassPass.

3. Reservation Management

As a ClassPass user, all reservations, cancellations, or changes must be made directly through the ClassPass platform.
Chosen Massage and Wellness cannot modify, cancel, or reschedule ClassPass bookings on behalf of the client.

3B. Arrival Time

Clients must arrive on time for their scheduled appointment.
Late arrivals will result in reduced session time to avoid impacting subsequent appointments.
Full service time is not guaranteed for late arrivals.

4. Adolescent Appointments (Under 18)

• A parent or legal guardian must be present for the entire session.

• A signature is required before the service begins.

5. Prenatal Massages

• Expecting mothers must be at least 14 weeks along to receive a prenatal massage.

• A doctor’s note may be required for high-risk pregnancies.

6. Professional Boundaries & Conduct

• Sexual harassment, advances, or innuendos are strictly prohibited.

• Any inappropriate behavior will result in immediate termination of the session, full charge of service, and a permanent ban from booking.

• This is a professional environment. Any violation of this policy will not be tolerated.

7. Guest Policy

• Only the client receiving the service is allowed in the treatment room.

• The only exception is for adolescent clients, who must have a parent or guardian present.

8. Liability Disclaimer for Personal Belongings

• Chosen Massage and Wellness and Ashley Bacon are not responsible for lost, stolen, damaged, or misplaced personal items.

• Clients are responsible for securing their belongings before, during, and after sessions.

• Clients release Chosen Massage and Wellness and Ashley Bacon from any liability for loss or damage of personal property.

• Not responsible for complications related to body piercings, modifications, or tattoos during/after session.

8B. Makeup & Skin Policy
I acknowledge that I will arrive for my session with clean, bare skin or minimal makeup. I understand that heavy makeup (foundation, bronzer, mascara, etc.) can stain or damage linens and face cradle covers. I agree that if any makeup causes damage, I will be responsible for a $15 non-refundable damage fee.

9. Liability & Health Disclaimer

• Not responsible for any sickness, injuries, allergic reactions, or health-related issues before, during, or after session.

• Not medical professionals—do not diagnose, treat, or prescribe medical conditions.

• Clients waive the right to pursue legal action for any injury, reaction, or health-related issue that may arise.

9B. STRICT HEALTH DISCLOSURE POLICY

For the health and safety of both the therapist and clients, you are REQUIRED to disclose ANY and ALL health conditions PRIOR to your appointment. This includes but is not limited to:

Herpes (oral or genital), shingles, cold sores, rashes, lice, or any contagious skin or viral conditions. If you have herpes and are experiencing an outbreak (genital or oral), or if you currently have lice or any contagious condition, YOU MUST reschedule your appointment for a later date. This is non-negotiable. If you arrive and it is discovered that you are having an active outbreak or failed to disclose a condition, your appointment will be TERMINATED IMMEDIATELY and you will be charged IN FULL.

Cancellation fees and policies still apply.

This is a clean, safe, and professional space. There is ZERO TOLERANCE for dishonesty or putting others at risk. Respect the space and the safety of your therapist and fellow clients.

10. Legal Protection & Jurisdiction

• Any disputes arising from services provided by Chosen Massage and Wellness will be governed by Tennessee state law.

• Legal action must be filed in Davidson County, Tennessee.

11. Faith-Based Practice

• This is a faith-based business. Only gospel music will be played, including worship, gospel R&B/hip-hop, and gospel instrumentals.

12. Agreement Enforcement

• By booking an appointment, you acknowledge that you have read, understood, and agreed to these terms and conditions, regardless of whether a signature has been provided.

Name*

First NameLast Name

Signature*

Today's Date*

Date

ClassPass Client Intake Form

ClassPass Terms and Conditions