A Spa to Remember | 3 Littleton Road Westford, MA 01886
( Do Not Confuse us with A Spa For You)
3 Littleton Rd Unit 1 | Westford, MA 01886
Westford/Chelmsford Line
(Formerly Of Chelmsford)
* Required
First and Last Name*
Phone Number*
Email Address*
Date of birth*
Address*
City*
State*
Zip Code*
Would you like to receive text messages of our weekly specials?* YesNo
Referred by*
Are you on Instagram? Follow us! @aspatorememberwestford*
Do you have any known allergies?*
Diabetes? * YesNo
Are you taking any topical medications? * YesNo
Are you taking any oral medications? * YesNo
If yes, please list:*
Are you under a Doctor’s care for any skin conditions?* YesNo
Are you presently using or have you used any of the following products in the past two weeks? Check all that apply. Glycolic AcidAlfra HydroxyTazaroteneErythromycinRetin ARenovaTretinoinDoxycyclineAccutaneAdapaleneMinocylineTetracyclineNoneOther
Have you ever experienced an adverse reaction to a waxing treatment?* YesNo
If yes, please explain:
We require a 24-hour cancellation notice or appointment rescheduling of all services. A Charge of 50% of the service will be incurred for all missed appointments.
Please note that this card will only be charged in the case of a same-day cancellation or a no-show appointment, please bring in a separate payment method at the time of your service.
Type of card* —Please choose an option—MasterCardVisaAmerican ExpressDiscover
Name on Card*
Card Number*
Expiration Date*
CVC Number*
By entering your name, date and signature below, you are effectively providing your signature, indicating that all the information on this form is true and accurate, to the best of your knowledge.
It has been explained to me that following the waxing procedure I should not be exposed to the sun for at least 48 hours. Avoid use of loofahs or any other abrasive exfoliants, steam room, sauna, or any other heat source for at least 48 hours. If area is red or sensitive after waxing, apply cold compress.
Thank you for answering these questions. This information enables us to provide you with the best possible services.
Sign Electronically in the empty space below: