Customer Record

RatoPicoasBelemOutro

Name *

Postal Code

City

Phone *

Email *

Birth date

Employment

Where did you hear about Float in?

Through Other PeopleInternetI received a voucherSocial networksOther:

If Other, please specify

Reason for Booking

Treatment Preferences

I want the pressure of the massage to be:

WeakAverageStrong

Some Health Issues: Please mention if you have had any relevant situation in the last 5 years (surgeries, cancer, high blood pressure, or skin problems, others)

Contraindications for Fluctuation: I am aware of the contraindications for fluctuation and confirm that I do not suffer from blood pressure, epilepsy and schizophrenia problems. I have no history of skin problems, vertigo, nausea or ear problems. I confirm that I am not under the influence of alcohol or drugs, i am not in menstruation phase and that i have not dyed my hair recently.*

Contraindications for Massage: I am aware and confirm that there are no health contraindications that prevent me from receiving this massage. *

I assume, for all due purposes, that all the information expressed above is true, and Float In is not responsible for any missing data or misleading statements, exempting it from any and all damage or loss that may result, also waiving any compensation or compensation. *

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