Oasis Massage and Spa- Pedicure and Body Wrap Form
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Email *
Name: *
Mobile Number: *
Address: (including zip code) *
Birth Date *
MM
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DD
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Emergency Contact *
Occupation *
I wish to receive appointment reminders via: *
How did you hear about Oasis? *
Concerns we need to know about: *
Statement of Understanding *
Our licensed estheticians do not diagnose, nor do they prescribe any medical treatment. To better the results of my facial, I have fully completed the above information to the best of my knowledge and recognize that my health information will be utilized by my esthetician only. My esthetician may choose to use surface peeling products during my facial, and I give consent.  I will contact my esthetician with any concerns or questions. Oasis Massage and Spa reserves the right to refuse service to any client for any reason; clients who appear to be under the influence of drugs and/or alcohol, will be turned away for their own safety and to protect the integrity of our service providers and their license.
Date Acknowledging the Statement of Understanding *
MM
/
DD
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YYYY
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