Salon Secrets Spa Massage and Facial Waiver









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General Health Questionnaire (check all that apply)

Massage

Pregnant
High blood pressure
Tension or soreness in a specific area


Facial

Current skin conditions (allergies, psoriasis, warts, poison ivy, etc.)
Sinus problems, seasonal allergies
Headaches, migraines, tension


Yes
No




Yes
No




Yes
No




Yes
No