Japanese Head Spa Consent Form

Client Information
How did you hear about us?
How did you booked your appointment?
Consent to treatment
Note:
  • The duration of this service is as indicated in the package you have selected. If you have any specific requests, please let us know to adjust the service accordingly.
  • We appreciate your feedback for future improvements, but refunds are not available once the service has been completed.

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Restrictions:
One time use only. Must show valid ID with your name at front desk.
Expire:
Serial Number: XXXXXX
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First Name *:
Last Name *:
Email *:
Phone *:
Birthdate *:
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