Oasis Massage and Spa Facial Form
The following is for our records only. We will not sell or give out your information.
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Full Legal Name: *
Mobile Number: *
Email: *
Address (including zip code) : *
Date of Birth: *
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Emergency Contact Name and number: *
Occupation:
How would you like to receive appointment reminders? *
How did you hear about Oasis?
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Please mark any that apply: *
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If pregnant, how many weeks?
What are you currently using to cleanse your face? *
What are you currently using to moisturize/protect?   *
Are you using any special treatments (eye cream, night cream, masks)?
What concerns do you have about your skin, and what improvements would you like to see? *
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: *
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