Facial Client Intake

Due to COVID-19, we have added a few more questionaires to the form and updated our Policies and Agreement. All clients (new or current) are required to complete this form prior to service. If you developed any sympton after completing this form and before your service, please give us a call to reschedule your appointment. The safety of our clients and staffs are our top priority.

Full Name*

First NameLast Name

Cell Phone*

Birth Date*

MonthDayYear

Address*

Street Address

Street Address Line 2

CityState

Zip Code

E-mail*

example@example.com

Occupation

Have you been tested for COVID-19? If yes, please list the date and result.

Have you been in places with a high infection rate or inside crowd within the last two weeks? If yes, please explain.

Please check if you are experiencing any of the following as a NEW PAATTERN since the beginning of the pandemic:

The use of drugs or alcohol prior to or during the sauna session may lead to
dizziness or unconsciousness.
Please contact and consult your physician if you are in doubt of your ability to
use the Sunlighten sauna for health reasons.
No clients under the age of 18 are permitted in the Sunlighten sauna unless
accompanied by a supervising adult.
Please discontinue the use of the Sunlighten sauna if you feel light-headed, dizzy
or heat exhausted.
Sauna sessions should be limited to a maximum of 45 minutes.
It is advised to drink plenty of water before and after your sauna session.
Clients using any medications must consult a physician prior to the use of the
Sunlighten sauna.
Pregnant women should not use the Sunlighten sauna.
Clients with a medical history of circulatory system problems should consult a
physician prior to using Sunlighten sauna.

I acknowledge and accept the risks inherent in the use of the Sunlighten sauna. I
voluntarily assume the risk of injury, accident, or death which may arise from the use of
the Sunlighten sauna. I and any of my heirs, executors, representatives, or assigns hereby
release from all claims or liabilities for personal injury or property damages of any kind
sustained while on the premises, during the use of the Sunlighten sauna and from any
advice provided by an employee, independent contractor or any representative.

I further understand that Farashe The Day Spa is NOT A Medical Doctor and is NOT
attempting to portray, or conduct the activities of a Medical Doctor and I release her, the
Facility and Manufacturer from any adverse effects I may incur by the use of the
Sunlighten sauna.

I have carefully read the above safety instructions for using a Sunlighten sauna. I fully
understand them and fully agree to comply with instructions. This agreement is in effect
for all Sunlighten sauna sessions/treatments and will not expire unless requested by either party.

By my electronic signature below, I agree to the spa policy and client agreement above.

Signature*

Sign by using a touch tablet/screen or left click and hold as you sign with your mouse.

Sauna Intake Form