2015-16 Complete Fitness & Spa Program

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MASSAGE / BODY SCRUB THERAPY PREFERENCES
Please indicate your areas of concerns. Please check all that apply:
 Stress Reduction
 Anxiety, Irritability, Fatigue, Insomnia
 Headaches
 Muscle Aches & Pains
 Neck, Shoulder, or Back Pain
 Injuries
Are you sensitive to touch or pressure? Yes No
What pressure do you prefer? Light Medium Heavy
How often do you receive massages?
Do you have a specific area you want focused on?
Do you suffer from arthritis or any vein issues? Yes No
Do you have any allergies? Yes No
Do you have any rashes or bruise easily? Yes No
Are you pregnant? Yes No
NAIL THERAPY PREFERENCES
Please indicate your areas of concerns. Please check all that apply:
 Dry skin, thin skin
 Nail Conditions
 Rough, calloused or peeling skin on the feet
Are you sensitive to touch or pressure? Yes No
What pressure do you prefer? Light Medium Heavy
How often do you receive Manicures? Pedicures?
Do you have diabetes? Yes No
Do you have any nail or toe nail infections? Yes No
Thank you for taking the time to complete this Spa Treatment Preference Guide.
Your responses to these questions will help us to serve you better.
MEMBER NAME:
MEMBER NUMBER:
GUEST NAME:
DATE: