Consultation Form

Your Details

Name *

Email * Phone Number *

Gender *

 

Age *

Date of Spa Appointment *

Who are you attending with

Additional People

Treatment Selection

Please choose a single treatment

Medical History

Do you have any existing medical conditions? *

Are you currently taking any medication? *

Have you had any recent surgeries or medical procedures? *

Do you have any allergies (e.g., food, medication, skincare products)? *

Dietary Requirements

Do you have any dietary restrictions or preferences we should be aware of? *

Are there any ingredients or types of food you are allergic to or prefer to avoid? *

Additional Information

Please bring more than one swimwear if you wish, as our spa facilities include wet and dry rooms. This will ensure your comfort throughout your visit.

Is there any other information you would like to share with us to enhance your spa experience?

Declaration

Name *

Date *

Submit