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Pure Spa Client Intake Form

Please fill out the following form to help me understand your needs.

Have you been hospitalized in the last 12 months?
Are you currently suffering from a medical condition, illness, or injury?
Please check all current conditions that apply to you:
1. You will receive 100% of your deposit if you cancel 48 hours (2 days) in advance. Please choose yes if you understand. *
2. Less than 2 day notice we will be unable to refund your deposit. If you need to reschedule, we will gladly offer an alternative date up to 1 month for your consideration. Please choose yes if you understand. *

Thanks for submitting!

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