SPA CONSULTATION FORM

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Prior to your visit to the Dartmouth Spa, please complete the following consultation form.

Are you currently under a doctor’s care and receiving ongoing treatment?

Do you suffering with any of the following? (please select all that apply)

What are your 3 main concerns with your skin? Please tick

What are your 3 main concerns with your body? Please tick

hereby consent to the use of my personal data (including any sensitive personal data) for the purpose of my treatment and any future treatment and confirm that any treatment is at my own risk without limiting or affecting any statutory rights I may have. I agree that any dispute or claim that arise out of, or is related to, such treatment and/or spa services shall be subject to the law and the exclusion jurisdiction of the courts of the country/region in which the relevant treatment/service took place.

Please confirm that you or anyone in your household haven't had or been in contact with anyone who has had covid 19 in the last 14 days

10 + 8 =

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CALL US ON 01803 712017