General Intake Form
First name
Last name
Do you have any medical conditions we should know about? (including allergies, pains, injuries, pregnancy, surgeries and etc.)
If yes, please list below:
This Customer Service Consent Agreement ("Agreement") is entered into by and between Sunny Massage, located at [Address], and the undersigned client ("Client"). By signing this Agreement, the Client consents to receive services from Sunny Massage and agrees to the following terms and conditions:
1. Scope of Services: The Client consents to receive massage, facial scalp treatment, and facial services provided by Sunny Massage. The Client acknowledges that these services are for relaxation and wellness purposes only and are not a substitute for medical treatment.
2. Assumption of Risk: The Client acknowledges that there are inherent risks associated with massage, facial scalp treatment, and facial services. The Client voluntarily assumes all risks, including but not limited to, physical injury, allergic reactions, or any other adverse effects that may result from these services.
3. Medical Conditions: The Client agrees to disclose any medical conditions, allergies, or medications that may affect the services provided. The Client understands that failure to disclose such information may increase the risk of adverse effects and releases Sunny Massage from any liability arising from undisclosed conditions.
4. Release of Liability: The Client releases and holds harmless Sunny Massage, its owner, employees, and contractors from any and all claims, demands, damages, or causes of action arising out of or connected with the services provided, except in cases of gross negligence or willful misconduct.
5. Indemnification: The Client agrees to indemnify and defend Sunny Massage, its owner, employees, and contractors against any claims, damages, liabilities, and expenses (including reasonable attorney's fees) arising from the Client's breach of this Agreement or any negligent or wrongful act by the Client.
6. Cancellation Policy: The Client agrees to adhere to Sunny Massage's cancellation policy, which requires [number of hours/days] notice for cancellations or rescheduling. Failure to provide such notice may result in a cancellation fee.
7. Governing Law: This Agreement shall be governed by and construed in accordance with the laws of the State of [State]. Any legal action or proceeding arising under this Agreement shall be brought exclusively in the courts of [County], [State].
By signing below, the Client acknowledges that they have read, understood, and agree to the terms and conditions of this Agreement.
This Agreement constitutes the entire understanding between the parties and supersedes all prior discussions or agreements regarding the subject matter herein.