New Client Intake Form

Thank you for trying out Remedy Me Spa. We cannot wait to serve you. Please take a minute to fill in the following information to help us make your experience the best possible.

First name

Last name

Birthday

Email

Phone

Country/Region

Address

Address - line 2

City

Zip / Postal code

What areas of your life do you hope floating will help improve?

Check as many that apply:

Physical Goals:

Mental Goals:

Any additional goals not listed above?

Are you able to safely get yourself in and out of the float spa?

Yes

No

Please bring an assistant with you, if needed, as the Remedy Me Spa, LLC, aka Remedy Me Float Spa, are not trained to provide assistance.

Fees: Various individual and multiple session rates are available base on the type of float spa. Cancellation policy: Cancellation prior to 24 hours of the scheduled session will be allowed to reschedule. Individual Sessions: Cancellation within 24 hours of the scheduled session or “no show” will forfeit the deposit and must be paid before any future appointments are scheduled. Multiple Sessions (package sessions): Cancellation within 24 hours of a scheduled session or “no show” will forfeit the cost of one session from the package purchased. Gift Certificates: Cancellation withing 24 hours of the scheduled session or “no show” will forfeit the session (one session if the Gift Certificate is for multiple sessions).

In order to have a safe and enjoyable experience, please read and acknowledge the receipt and understanding of the following information: Facilities: Floor surfaces may be wet or slippery. Please take caution to prevent falling or slipping. Sanitation: The spa room is cleaned between client sessions to meet or exceed the Flotation Tank Association standards and Covid health practices. The float tanks are self-sanitizing. The solution contained therein is a highly concentrated salt solution and each tank has three filtering systems.

Please review and agree that you understand each of the following requirements for float spa sessions:

I am at least 16 years of age.

I will shower to remove any oils, creams, deodorant or makeup from my hair and body at the spa before my session.

I will not float if i had any of the following services in the time period listed: (lash/nail esthetics in the last 24 hours) (microblading in the last 7 days) (tattoos in the last 4-6 weeks).

I will not float if I had any of the following service in the time period listed: hair/color treatment in the past two (2) weeks or will adhere to a white towel test.

I have not had a spray tan or self-tanning lotion in the past 10 days prior to my float session.

If I am experiencing a heavy menstrual period, I will reschedule at least 24 hours prior to my session.

I am not on any treatments for cancer, such as chemotherapy and/or radiation.

I am solely responsible for my electronic device if brought into the spa.

I am not under the influence of any alcohol or illegal drugs.

I am under a physician’s care for the following conditions and have approval to participate in float spa session(s):

Any other issues not listed above...

I fully understand that violation of these requirements that result in contamination of the float solution will result in a cleaning/salt replacement fee of up to $1,000.00 and a $55.00/hour downtime charge.

I am choosing to utilize the float spa services at Remedy Me Float Spa of my own free will and will not hold the owner/operator, staff or Remedy Me Spa, LLC aka Remedy Me Float Spa liable for any injury before, during or a session while on the premises. I fully understand that every effort is made to protect the health and safety of clients while enjoying the Float Spa services, there can be unforeseen risks and hazards.

Remedy Me Spa, LLC, aka Remedy Me Float Spa reserves the right to refuse service to anyone at any time.

I have read, fully understand, and agree with the information provided herein and will be compliant during the current and all future spa sessions.

Signature