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480.647.7927
(Pronounced Skinny Spa)
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Must be completed prior to consultation
new client submission forms
New Client Info
How did you hear about us?
Sola Salon Studios
Facebook / Instagram
Google / Yelp
TV / Media
Referral / Word of Mouth
Other
Which feature attracted you to SkinE Spa?
Weight Loss / Fat Loss
Spot Reduction / Cellulite
Skin Rejuvenation / Anti-Aging
Pain Management / Detoxification
Which lifestyle best describes you?
Active / Healthy Diet
Active / Unhealthy Diet
Moderately Active / Healthy Diet
Moderately Active / Unhealthy Diet
Inactive / Healthy Diet
Inactive / Unhealthy Diet
How much water do you drink each day?
More than 64 ounces
32 - 64 ounces
Less than 32 ounces
None
What is your BMI Range?
Normal weight
Overweight
Obese
Do you suffer from any of the following?
Hepatitis C/D
HIV / AIDS / Hepatitis
Pacemaker / Cardiovascular Conditions
Autoimmune Disease / Diabetes
Thyroid Problems
Pregnant / Breast Feeding
Orthopedic Injuries / Metal Plates or Pins
Under 18
N/A
Submit
Thanks for submitting!
Planning Ahead
Treatments need to be at least 72 hours apart. Which 2-day schedule will work best for you?
Monday, Thursday
Tuesday, Friday
Wednesday, Saturday
Treatments take 1-2 hours, depending on the plan. What time of day will work best for you?
9 am - 12 pm
12 pm - 3 pm
5 pm - 9 pm
Depends on which day
Our liver detox and 9-day cleanse will greatly improve the effects of your treatments and ultimately enhance your results. Would you like to learn how to incorporate this into your treatment program?
Yes, I want to get the most out of my treatments
No, I'm not interested
I'm not sure. I'd need to know more
Do you experience one of the following?
Claustrophobia
Chronic pain
Heat sensitivity
N/A
Would you like to learn more about other services offered through SkinE Spa?
Weight Loss / Nutrition
Reiki Healing
MIndset Coaching
Lifestyle Design Coaching
N/A
Submit
Thanks for submitting!
Download Treatment Guidelines
Download Consent / Release Form