Spa Consultation Form

Spa Consultation

* = mandatory field

The Spa Safety Policies

Please avoid the following activities for up to 12 hours after any treatment: Sauna, Steam Rooms, Jacuzzi, sunbathing, unprotected exposure to sun and UV rays. The Spa cannot treat clients with conditions such as herpes simplex, cold sores, open wounds, healing incisions, verrucas, warts or fever blisters. The Spa cannot treat clients with deep skin peeling conditions. The Spa cannot accept the responsibility for jewelry or other valuables that are removed or misplaced in or around the spa.

Are you currently under medical supervision or treatment? If so, please give details:

To ensure you receive the best treatment possible, we need to be familiar with your medical history. Please make us aware of any of the following conditions that you may be experiencing now or that you have done in the past, by ticking the appropriate boxes:

Medical Conditions
Cancer ConditionsPlease, tick the applicable in your case:
Please, explain further:
Have you recently completed or scheduled treatments ahead of your stay with us? Please specify the treatment/therapy and date of completion/scheduling.

I understand that services received at The Spa are not a substitute for medical or dermatological treatment and that any information given by a therapist is for educational purposes only and should not be construed as medical advice. I have read and understood The Spa’s safety policy and have accurately completed my medical history. I understand that I should not receive treatments whilst under the influence of alcohol or drugs. I understand that I have treatments entirely at my own choice and risk and that The Spa at Cashel Palace Hotel takes no responsibility whatsoever for any injury, reaction or results that might occur following a treatment or use of any of The Spa’s facilities.

Private & Confidential Lifestyle Consultation

Please tick boxes or complete answers as appropriate.
Please tick more than one answer if applicable

Lifestyle
Daily consumption of water?
How would you describe your lifestyle?How would you describe your lifestyle?
Do you feel you manage your stress level well? Does stress affect your:Do you feel you manage your stress level well? Does stress affect your:
Do you smoke? *
Do you take some form of exercise daily? *
Do you wear hearing aids? *
Face
Which of the following are concerns for you?Which of the following are concerns for you?
For male clients only
Do youDo you
Sensitivity After ShavingDo you ever experience sensitivity after shaving?
In-growing hairsDo you experience in-growing hairs on the beard or neck areas?
For female clients only
Are you?Are you
Do you suffer with concerns fromDo you suffer with concerns from:
Body & Mind
Body & Mind ConcernsDo you have concerns about, or are you experiencing, any of the following:
What areas of the body do you feel you need to work on?What areas of the body do you feel you need to work on?