Tell us a little about yourself

Please complete the following intake form before your appointment. We take privacy very seriously. Your personal information will never be shared.

*IMPORTANT: Did someone forward this to you? If so, please note that it will not work properly. Instead, we will have a physical intake form for you at the spa on the day of your appointment. (your email address must already be in our system to save your entry.)

General Information

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Esalen Massage

Only necessary if you are receiving a massage.
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Salt Water Floatation

Only necessary if you are floating

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Massage Liability I understand that the massage I receive is provided for the basic purpose of relaxation and relief of muscular tension. If I experience any pain or discomfort during this session, I will immediately inform the therapist so that the pressure and/or strokes may be adjusted to my level of comfort. I further understand that massage should not be construed as a substitute for medical examination, diagnosis, or treatment and that I should see a physician, chiropractor or other qualified medical specialist for any mental or physical ailment that I am aware of. I understand that massage therapists are not qualified to perform spinal or skeletal adjustments, diagnose, prescribe, or treat any physical or mental illness, and that nothing said in the course of the session given should be construed as such. Because massage should not be performed under certain medical conditions, I affirm that I have stated all my known medical conditions, and answered all questions honestly. I agree to keep the therapist updated as to any changes in my medical profile and understand that there shall be no liability on the therapist’s part should I fail to do so.

If I make any sexual advancements or innuendos the session will be terminated immediately without a refund.

Floatation Liability I agree to check myself, care for myself, and be fully responsible for myself as I use the floatation chamber, shower, and room and as I travel in and move upon the surfaces of both my mind and my physical and emotional environments. I have made no misrepresentations to Still Point Wellness, or any of it’s agents, or employees, regarding my physical or mental conditions. I accept and expressly assume for my use the isolation tank, shower, and room facilities and accept full responsibility. I hereby agree and accept the terms and conditions of this contract and acknowledge that Still Point Wellness has provided no warranties, expressed, oral, or implied, about my expectations being met or anticipated, or unforeseeable experiences. I hereby agree to freely and expressly assume and accept any and all risks of injury and release Still Point Wellness from liability should injury occur. Still Point Wellness does not condone the use of drugs and/or alcohol while using the salt water floatation chamber. I agree to abstain from using drugs or alcohol while I am in the floatation chamber.

Cancellation Policy
I agree to give 48-hour notice if I choose to cancel an appointment for any reason. If I cancel without 48-hour notice, I agree to pay in full.