WELCOME TO TEMPLE DAY SPA Before your decadent Temple experience, we have a few questions we need to as you. What is your first name? What is your last name? What suburb do you live in? What is the postcode? What is your date of birth? (ie. 01.09.85) What is your email address? What is your mobile number? How did you find out about us? How did you find out about us?Online Search (Google, Bing etc.)Social MediaWord of MouthMagazine/NewspaperRadio/TVEmail NewsletterOther An emergency contact name and number An emergency contact name and numberOnline Search (Google, Bing etc.)Social MediaWord of MouthMagazine/NewspaperRadio/TVEmail NewsletterOther Are you currently pregnant Are you currently pregnant Yes No If yes, how many weeks pregnant are you If yes, how many weeks pregnant are youOnline Search (Google, Bing etc.)Social MediaWord of MouthMagazine/NewspaperRadio/TVEmail NewsletterOther Are you currently using Retinol, Retin-A or Roaccutane Are you currently using Retinol, Retin-A or Roaccutane Yes No If yes, how long have you been using this If yes, how long have you been using thisOnline Search (Google, Bing etc.)Social MediaWord of MouthMagazine/NewspaperRadio/TVEmail NewsletterOther Have you undergone any laser resurfacing (IPL) in the last 3 months Have you undergone any laser resurfacing (IPL) in the last 3 months Yes No Please provide us with a brief medical history of any surgeries, medical illnesses, operations or injuries Please list any allergies we should be aware of Do you have any of the following Do you have any of the following Varicose veins Warts Bruising Swelling Diabetes Skin disorders Heart condition Osteoporosis Metal implants Epilepsy Pacemaker Have you had any botox or fillers Have you had any botox or fillers Yes No If yes, how long ago was this If yes, how long ago was thisOnline Search (Google, Bing etc.)Social MediaWord of MouthMagazine/NewspaperRadio/TVEmail NewsletterOther What massage pressure do you prefer What massage pressure do you prefer Firm Medium Light List any areas of tension Have you received treatment for cancer in the last 6 months Have you received treatment for cancer in the last 6 months Yes No What kind of results would you like to see with your skin 13 + 4 = CHECK IN
