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Facial Sculpting Massage

Client Details, Consent & Acknowledgement


This form contains details and health disclosure to enable Flow Massage Wanaka to provide the Client with our massage services and your consent to receive our Services.

What is your average level of physical activity?
What is your average sugar consumption?
Have you had any injectables, fillers, botox or other cosmetic or invasive procedures in the last 6 week?

Consent to receive our Services
By using our Services:

Age: You confirm that you 18 years old or over.

Frequency: You acknowledge that the optimal number of sessions per massage course is 6-12, and that a massage course is recommended 1-2 times a year.

Consent: You have read, understood and acknowledge the possible Risk of Harm and consent to receive the Services.

By using our Services, you acknowledge and agree:

Not Medical Advice or Treatment: Neither this form, any content available on our website nor any disclosures we make in person are an attempt to practice medicine, provide medical advice or diagnose, treat, cure, or prevent any disease or condition. It is not a substitute for professional medical advice or medication based on your personal circumstances. It is not to be used or relied on for any diagnostic or treatment purposes. Use of this form or any materials available on our website or our Services does not establish a doctor-patient relationship. Any health information in this form or any materials available on our website or in person is provided simply for your convenience. If you have any medical concerns, you should consult a health care professional before using the Services. Do not make changes to any current treatments or medications you are using without referring to your health practitioner.

Medical Sign-off: You confirm that you have no medical condition which would prohibit you from using our Services. You confirm that the medical information that you have provided to us via the Client Health Disclosures is truthful, accurate and up-to-date. You understand and agree that if you do not provide accurate, truthful and up-to-date information, this may adversely impact the Services provided by us and be a health risk for you;

Results Vary: The results of our Services do vary, and that no guarantees of specific results are offered or implied. To the extent permitted by law, we will not refund or credit any amount of money because of your unhappiness with the results. While we endeavour to keep information about our Services up-to-date and correct, we make no representations or warranties, express or implied, about the accuracy, completeness or suitability for any purpose of the information, and we do not accept any liability for any injury, loss, or damage incurred by actions taken by you as a result of, or your use or reliance on, the information provided, to the maximum extent permitted by law.

Information and Updates:

The information contained in this form and on our website in respect of the Services is for
general information purposes only and is in no way intended to be medical advice, treatment or diagnoses. It does not take into account your own personal circumstances. We make no warranties as to the appropriateness and suitability of our Services for you.

Thanks for submitting!

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