Head Spa Consultation Form

Name

Date of Birth

Phone Number

Are you currently under the care of a physician?

Do you have any allergies?

Do you have any skin conditions or sensitivities

How would you describe your hair length, thickness and texture?

How would you describe your scalp condition?

Have you experienced any scalp irritation or discomfort recently?

Have you received any scalp treatments in the past?

How often do you wash your hair?

Do you frequently use heat styling tools?

Do you have any dietary issues or preferences that may affect your scalp health?

Do you have any other concerns that may affect your treatment?

Head Spa Consent Form

Booking Terms

All customers pay a 50% non-refundable booking fee to secure the appointment slot (deposit doesn’t apply to infills). If unable to attend your appointment, you can move the appointment once before losing the deposit.

If an appointment is cancelled or amended within less than 48 hours a £20 charge will apply. (If appointment is moved to an appointment in the same week, only £10 will be charged.

Less than 24 hours’ notice, or no shows will be charged the full cost of the treatment.

We are unable to keep your appointment if you are more than 15 minutes late – this is treated as a cancellation.

Payment of the cancellation charge would need to be made before any further bookings are confirmed. Any scheduled appointments will be cancelled until the outstanding amount is paid. If payment isn’t received within 24 hours all appointments will be cancelled and you will not be allowed to book in for the future.

We hope you appreciate that this policy ensures that we are able to offer the best possible service to all of our clients.

Head Spa Treatment

The Japanese Head Spa treatment involves various techniques and products designed to promote scalp health, improve circulation & enhance relaxation.

These may include but are not limited to:

Scalp massage
Application of oils, creams or other products to the scalp
Steam therapy
Use of specialised tools for scalp stimulation

While the Japanese Head Spa treatment is generally safe, there may be risks associated with it, including but not limited to,

Skin irritation or allergic reactions to products
Discomfort or pain during the treatment
Rare incidences of adverse reactions to massage or stimulation techniques

Name

Date of Birth

I acknowledge that the Japanese Head Spa treatment involves various techniques and products as detailed above.

I acknowledge that while the Japanese Head Spa treatment is generally safe, there may be risks associated with it, including but not limited to those mentioned above.

I understand that it is my responsibility to inform the therapist of any allergies, sensitivities, or medical conditions that may affect my ability to safely undergo the treatment.

I acknowledge that the therapist has explained the treatment process to me, including any potential risks, and has answered all my questions to my satisfaction.

I consent to receiving the Japanese Head Spa treatment, understanding the risks involved and release Renew by RJ and its staff from any liability associated with the treatment.

I have read, fully understand and agree to the booking terms.

Deluxe Japanese Head Spa

This deep scalp detox treatment combines Japanese scalp massage techniques with a luxurious cleanse to remove buildup, improve circulation, and promote hair growth stimulation. Designed to rejuvenate both scalp and hair health, our Japanese Head Spa in Essex is perfect for those seeking ultimate relaxation and scalp revitalisation. Your consultation helps us tailor the treatment to your needs, ensuring the best possible results.

Head Spa Consultation Form

Head Spa Consent Form

Deluxe Japanese Head Spa

Treat yourself

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