Welcome to Nuansa Spa

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   Your personal preferences*:

   Are you experiencing the following conditions*:

   Please advise your therapist if you have a history of*:

I have completed this form to the best of my knowledge. I have stated all medical conditions that I am aware of and I understand that Therapists do not diagnose illness, disease, or physical or mental disorders, nor do they prescribe medical treatments or perform spinal manipulations. I understand that any illicit or sexually suggestive behavior, remarks or advances made by me will result in the immediate termination of the session and I will be liable for full payment of the scheduled service. All information received is held in the strictest of confidence and will not be disclosed to outside sources.