• New Client Intake Form

    Please complete this form to register as a new client.
  • Date*
     - -
  • Date of Birth*
     . .
  • Format: (000) 000-0000.
  • Sex
  • Music Preference: What music would you like during your appointment?*
  • Social Media Source*

  • Health History

  • Do you have any of the following conditions?*
  • Are you pregnant or think you may be pregnant?

  • Surgical History

  • Do you currently have any of the following?
  • What are your main goals?

  • Consent & Liability Waiver

  • I understand that the services provided at Viri’s Detox & Sculpting Studio are non-invasive and designed to support the body’s natural processes.

     


    I acknowledge that results may vary from person to person and are not guaranteed.

     


    I confirm that I have disclosed all relevant medical conditions and history to the best of my knowledge.

     


    I understand that these services are not a substitute for medical care and I have been advised to consult a healthcare provider if needed.

     


    I release Viri’s Detox & Sculpting Studio and its practitioner from any liability related to services performed.

  • To support optimal results from your treatment, please follow these aftercare guidelines:

     


    • Drink plenty of water (at least 2–3 liters within 24–48 hours)

    • Avoid alcohol for 24 hours

    • Avoid heavy meals immediately after your session

    • Engage in light movement (walking is encouraged)

    • Avoid intense workouts for 24 hours unless advised otherwise

    • Follow any personalized recommendations provided during your session

     


    I understand that following these aftercare instructions is essential for achieving the best possible results.

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