PRENATAL TREATMENT CONSENT FORM

Congratulations on your pregnancy. Mana Ola Spa is pleased to offer specially designed prenatal treatments intended to promote relaxation and comfort during this special time.
For your safety, please review and complete the information below.

Prenatal Treatment Consent Form
GUEST PREGNANCY INFORMATION
GUEST PREGNANCY INFORMATION
First Name
Last Name
Have you consulted with your physician or healthcare provider regarding spa treatments during your pregnancy?

IMPORTANT SAFETY INFORMATION:

For safety reasons, the spa may limit or modify certain treatments during pregnancy.
The following treatments are typically NOT performed during pregnancy:
 
  • Deep tissue massage
  • Heat-based body treatments
  • Certain essential oils
  • Detoxifying body wraps
  • Hydrotherapy or high heat environments (steam or sauna depending on spa policy)
Your therapist will adapt the treatment to ensure maximum safety and comfort.
 

MEDICAL DISCLOSURE:

Please indicate if you have experienced any of the following during your pregnancy:

PRENATAL CONSENT:

I understand that prenatal spa services are intended for relaxation and wellness only and are not a substitute for medical care.
I confirm that:
 
  • I have disclosed all relevant medical information
  • I will notify my therapist immediately if I experience any discomfort during treatment
  • I accept responsibility for consulting my healthcare provider regarding spa services during pregnancy
 

GUEST CONSENT:

I voluntarily consent to receive prenatal spa treatments and release Mana Ola Spa and its staff from liability except in cases of gross negligence.
By typing your name you are providing your legal and authorized signature.

Therapist Signature: