New Client Card

Dear New Lyftaal Client

This form is to be completed if you are visiting us for the very first time and have already made your booking. Kindly complete and sign the below information before your first treatment. Should your type of treatment require additional information, we will direct you to fill out any other applicable forms.

PLEASE DO NOT FILL OUT THIS FORM TO MAKE A BOOKING.
BOOKINGS CAN ME MADE VIA WHATSAPP, CALL OR EMAIL.

Kindly visit our contact page for details.

New Client Card

Full Name

City/Town of Residence

Phone Number

Date of Birth

Do you have any serious medical condition or allergies that we need to be aware of?

How do you prefer your massage pressure

Light

Medium

Firm

Please share with us what your expectation of your visit to Lyftaal is?

Where did you hear about us?

I agree that : * I have, following consultation, consideration and discussion, agreed to undergo this treatment and use the homecare products prescribed to me. I have had the procedures and products explained to me and understand the nature thereof. I acknowledge I have given my personal details for the therapists use. I understand that my information is protected and I give my consent for the company to store and use my details. I understand that if I have been untruthful with my details or have failed to give enough relevant information any treatment could be adversely affected.

Yes

Message

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