Release Form - Spa Therapies

top of page

OVS VARIA AESTHETICS

Home
Natural Spa Treatments
- Relax & Rejuvenation
- Health & Wellness
Forms
- Release Form - Spa Therapies
- Intake Form
Contact
More

Use tab to navigate through the menu items.

RELEASE FORM - SPA THERAPIES

Natural spa therapies are not suitable for everyone all of the time. There are risks associated with performing spa therapies on individuals with the following conditions:

Bruises
Pregnancy
Diabetes
Inflammatory skin conditions
Open wounds, sores, or thinning skin
Hypotension or Hypertension
Cancer (with or without treatment)
Varicose veins
Under the influence of drugs or alcohol
Blood clot(s)

Cardiovascular disease
Neuropathy
Autoimmune condition (MS, Lupus, RA, etc.)
Peripheral vascular disease
Heat sensitivity
Compromised immune system
Edema or Lymphedema
Blood thinning medications
Heat sensitivity
Under the influence of drugs or alcohol

Any of the above named conditions may make your treatment contraindicated or may require your therapist/practitioner to alter the treatment for your safety and wellness. You MUST inform your massage therapist/practitioner if you have any of the conditions listed above.

Declaration

Do you have any of the conditions listed above?

Yes

If YES please tick this box to indicate that you have a condition(s) that is listed above and acknowledge this makes your treatment contraindicated. Given this knowledge, you hereby give your full consent to receive your chosen treatment and take full responsibility for any side effects or harm that may come from your receiving treatment.

The therapist/practitioner has discussed this information with me and provided opportunity for any questions.

I have read and I fully understand the aforementioned conditions which make spa treatments contraindicated.

I have disclosed any and all health risk factors.

I understand that I will be receiving natural spa treatment(s) as an adjunct form of healthcare only, and that all therapies are not meant to replace appropriate medical care.

I understand the risks of bruising and muscle soreness that may occur directly or indirectly from treatments..

I release the therapist/practitioner and business of any and all liability for any harm that may unintentionally occur during my treatment(s).

I accept terms & conditions

First Name

Last Name

Emergency contact

Your Signature

OVS VARIA AESTHETICS

ovs.aesthetics@gmail.com

bottom of page