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HOME
SERVICES
WHAT'S NEW
SPA HOURS & CONTACT
NEW CLIENT CHECK IN
RETURN CLIENT CHECK IN

HOME
SERVICES
WHAT'S NEW
SPA HOURS & CONTACT
NEW CLIENT CHECK IN
RETURN CLIENT CHECK IN

RETURN CLIENT

MASSAGE INTAKE AND APPOINTMENT CHECK IN

Please read fully and complete this page prior to your appointment at the Sugar Hut Express Spa

Full Legal Name*

Appointment Day*

Any changes in contact information; medical conditions your therapist should know about? If so, please explain*

Appointment Type (check all that apply)

Signature Body Oil MassageSignature Foot MassageSignature Body ScrubThai Stretch MassagePrenatal MassagePink Quartz Facial Massage (30 min)Bamboo MassageDry Body MassageHead & Shoulder MassagePink Quartz add-on (10min)Thai Stretch add-on (10 min)Body Scrub add-on (15min)

DISCLAIMER & WAIVER. Because a Massage Therapist must be aware of any existing physical conditions that i may have, I have listed all my known medical conditions and physical limitations and I will inform my therapist of any changes in my physical health. I understand and agree that: (1) the massage therapy that I am given is for the purpose of stress reduction, relief for muscular tension or spasm and/or for improving blood circulation; (2) that a massage therapist neither diagnoses illness, disease or any other medical, physical or mental disease/condition, nor performs any spinal manipulations; (3) I am responsible for consulting a qualified physician for any physical ailments that I may have and prior determination of whether I am physically fit and in good medical condition to receive a massage. I AM FULLY AWARE OF THE RISKS INVOLVED AND HAZARDS CONNECTED WITH SKIN CARE TREATMENTS AND/OR MASSAGE THERAPY, AND I VOLUNTARILY ASSUME FULL RESPONSIBILITY FOR ANY RISKS OF LOSS, PROPERTY DAMAGE, OR PERSONAL INJURY THAT MAY BE SUSTAINED BY ME AS A RESULT OF THE ABOVE TREATMENT(S), OR ANY LOSS OR DAMAGE TO PROPERTY OWNED BY ME AS A RESULT OF BEING ENGAGED IN SUCH AN ACTIVITY AS THE ABOVE TREATMENT(S), WHETHER CAUSED BY NEGLIGENCE OR OTHERWISE. I HOLD THE SUGAR HUT EXPRESS SPA, ITS OFFICERS, STAFF, AND AGENTS HARMLESS AGAINST LIABILITY. Further, I have expressly represented that I am a return client who has previously provided information as requested in the initial intake sheet and incorporate all waivers of liability herein.*

I have read fully and agree to the above disclaimer & waiver. By checking the box, I subscribe my name and execute my authorization for treatment

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Thank you for completing your Massage Intake Sheet and Check In

We support reduction of paper! Please fill out this page within 24 hours of your next appointment.

XYZ Corporation. All Rights Reserved.

Ste 204B Guam Business Center

Rte 16, Harmon

Guam, 96915

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