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Experience the art of Japanese relaxation – reserve your spot at Miyabi Spa
TREATMENT FRO HER
*
Awaken
Restore
Transform
TREATMENT FOR HIM
*
45 minutes - Price $100
60 minutes - Price $160
Options
*
30 minutes - Price: $80
60 minutes - Price: $140
90 minutes - Price: $230
HAIRSPA
*
45 minutes - Price $100
Date (Sunday we are closed)
Time
General Health & Medical History
Do you have any scalp conditions (e.g., eczema, psoriasis, dandruff, open wounds, or infections)?
Have you experienced recent head, neck, or spinal injuries?
Do you have a history of migraines, chronic headaches, or dizziness?
Are you currently under treatment for any medical condition?
Do you have any allergies to essential oils, shampoos, or natural ingredients?
Do you suffer from high blood pressure, low blood pressure, or circulatory issues?
Do you experience frequent fainting, vertigo, or balance problems?
Do you have any nerve-related conditions affecting your head, neck, or shoulders?
Is your scalp sensitive to touch or certain products?
Do you have known skin allergies (e.g., to fragrances, herbal extracts, or essential oils)?
Have you recently undergone any scalp treatments, hair coloring, or chemical processes?
Do you often feel tension in your head, neck, or shoulders?
Do you experience high stress, anxiety, or sleep difficulties?
Would you prefer stronger or gentler massage pressure?
Are you pregnant or breastfeeding?
Are you taking any medications that may affect your skin, circulation, or sensitivity?
Would you like the therapist to avoid certain areas (e.g., temples, neck, shoulders)?
If yes, please explain:
Consent for Photos & Videos (optional)
I give permission for photos and/or videos taken during my appointment to be used for marketing and social media purposes.
☐ Yes, I agree
☐ No, thank you
Media Consent (optional)
I consent to the use of my photos and/or videos taken during my appointment for promotional purposes, including social media, website, and advertising. I understand my images will be used respectfully and I can withdraw consent at any time by contacting you.
☐ Yes, I agree
☐ No, I do not agree
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