Finesse Wellness Solutions Pre-Visit Customization Form
Name
*
First Name
Phone Number
*
Format: (000) 000-0000.
Are you left or right handed?
Thank you so much for taking time to customize your Wellness experience. Are you a NEW client or CURRENT client?
*
Thank you so much for taking time to customize your Wellness experience. Are you a NEW client or CURRENT client?
*
Are you allergic to Eucalyptus, Thyme, Magnesium, Peppermint or Lidocaine products?
Please Select
Yes
No
Please list any past or recent Injuries or surgeries? If none type NA:
LUX Aroma Therapy is included in your session and is optional. Please select:
Please Select
Lemon Bliss
Eucalyptus Joy
No not today. Thank you
Your LUX wellness session includes customized meditation music. Please select:
Please Select
No preference. Surprise Me
Finesse Mental Meditation Sounds
Classic R&B Music
Smooth Jazz
Rainfall Meditation
No Sound
LUX Skin Toning/Cellulite/Lymphatic hydration is included in your session and is optional. Please select:
Please Select
Yes
No not today. Thank you
LUX Herbal Foot soaking is included in your session and is optional. Please select:
*
Please Select
Yes
No not today. Thank you
What type of Muscle Wellness are you interested in? Swedish, Deep Tissue, Lomi Lomi, Sensual or Combination
Please Select
Swedish
Deep Tissue
Lumi Lumi
Sensual
Combination (We will customize upon arrival)
Preferred Massage Pressure? Soft, Medium, Firm or Combination (Medium/Firm)
What are your specific concerns at this time regarding your muscles?
What is your stress level right now?
Low
Average
Somewhat Stressed
Very Stressed
What is your goal for this session?
Do you perform daily stretching exercises?
Do you have a favorite beverage? (We offer tea, juice, soda, water and light alcoholic beverages.)
Finesse Wellness Solutions has partnered with Nutritional (Natural GLP-1 Gut Health Supplements) and Mental Health/ Meditation services for INCLUSIVE IMPACTFUL wellness. Would you be interested in any of these services?————————————————————— If YES information will be provided to you after your Muscle Wellness session.
Signature
*
Date
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Month
-
Day
Year
Date
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