PLEASE READ, INITIAL & SIGN
A salt scrub is a full body exfoliating treatment giving skin a softer feel and smoother appearance, and can move the lymph and promote circulation. Warm water is poured over the body to rinse all products off. Products that may be used in scrub treatments: honey, salt, cocoa butter, body wash, essential oils, rosewater, apricot oil, hair shampoo/conditioner.
A mud wrap is a full body deep relaxation treatment that increases circulation and refines the skin. After an application of botanical mud, client is wrapped in muslin and a blanket. Body compressions and foot scrub are given while wrapped and products are washed off with body wash. A coconut shea butter mixture is applied to nourish the skin. Products that may be used include: kaolin clay, lavender, chamomile, rosehip, honey, apricot oil, coconut oil, shea butter, essential oils, and body wash.
I understand the benefits and risks of body scrubs and wraps and give my consent for treatment. If I experience any pain or discomfort during the session, I will immediately inform the practitioner. I understand the practitioner reserves the right to refuse services for reasons of safety or should my needs exceed the practitioner’s knowledge, skill, and abilities or scope of practice.
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I understand I must be capable of getting on and off the table as well as turning over unassisted. If I am unable to turn over without assistance, I recognize that I have the right to provide a person to assist me.
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I confirm that I do not have any of the following conditions which are contraindicated for a body scrub and mud wrap.
- Full body or 2nd degree+ sunburn
- Using prescription exfoliants (i.e. Accutane)
- Varicose Veins
- Acute inflammation or infection
- Viral infection
- Cancer and malignant tumors
- Communicable skin condition, inflammation, eruption or infection
- Recently consumed alcohol
- Under the influence of drugs
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I understand there are certain conditions which may be aggravated by or require special attention before receiving a body scrub or mud wrap. If I have any of the following conditions, I agree to inform my practitioner immediately and use caution when receiving this service:
- Eczema
- Sensitive skin
- Cuts, abrasions
- Allergies
- After shaving
- Thin skin
- Open Lesions or Wounds
- Pregnancy
- Recent surgery and scars
- Local fungal infection
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If for any reason I feel my well-being is threatened or compromised or if I feel uncomfortable during the session I agree to notify the practitioner and management. I acknowledge I have full authority and responsibility regardless of the reason to determine if and when I may want the treatment paused, changed or stopped.
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I understand that Banya 5 has a no-tolerance policy for any sexual acting-out behavior and agree to adhere to this policy. My therapist has the right to end the session at any time.
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I acknowledge that Banya 5 requires a 24-hour notice for all appointment cancellations. That failure to provide this notice will result in an automatic charge up to the full amount of the services cancelled.
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