Whittlebury Park | Conference Centre, 4* Hotel & Spa

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Arrival Date at Whittlebury: (required)

Personal Information:

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Address 1:(required)

Date of Birth: (required)

Contact Number:(required)

Please be assured our Reservations Team and therapists have your health and well-being at the forefront. If you have any of the below medical conditions listed there may be a risk or restriction to treatments and the use of facilities. It is a requirement to contact our spa team prior to your visit to discuss any medical conditions highlighted to ensure you make the most of your spa day.

Medical Information:

Please specify details:

If you have ticked any of the above boxes, please provide details:

*For these conditions you may require a doctors certificate to participate in a treatment.

Have you ever been diagnosed with cancer?:(required)

Yes

The SATCC (Standards Authority for Touch in Cancer Care) recommends no exposure to heat above body temperature - around 37 degrees. This will include all saunas, steam rooms, and the sanarium. However both our hydrotherapy pool and Jacuzzi pool sit under this temperature which we encourage you to use within your own comfort level.

Are you currently undergoing treatment for cancer?:(required)

Yes

Are you currently pregnant?:

Yes

If 'yes' how many weeks?:(required)

Do you take any form of medication?:(required)

Yes

If you do take any form of medication, please state:

Do you suffer from any food allergies?:(required)

Yes

If you do suffer from food allergies, please state:

Do you suffer with any skin allergies?:(required)

Yes

If you do suffer from skin allergies, please state both botanical and commonly used name of ingredient:

Please note, that Whittlebury Park is not an allergen free site. Whittlebury Park is unable to cater for persons with airborne allergies and recommends for the individuals safety and wellbeing that they do not visit. Persons with an airborne allergies that would still like to are required to sign a disclaimer of understanding to acknowledge the potential risks, stating they still wish to attend. Please contact our Reservations Team on 01327 850 489 as soon as possible before your arrival.

Are your allergies airborne?:(required)

Yes

I agree to the Terms and Conditions

(required):

Yes, I agree

Marketing Information:

How did you hear about us?:(required)

By ticking the box above, I hereby acknowledge that upon using the Leisure Club facilities, I am accepting that it is my own responsibility to adhere to the Leisure Club safety guidelines which include use of the following safety equipment at all times; safety clips on exercise machines; yellow safety catches on smith machine; barbell safety clips. Appropriate footwear must be worn in the gym. Any injury or accident caused by failing to comply with such guidelines is not the fault of Whittlebury Park.:(required)

I agree to the above and will be using the gym

I will not be using the gym

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Please note that if you have already signed up to an existing newsletter, this form will only add you to additional newsletters and communications. You can change your preferences by clicking the "change your preferences" link in the emails you receive from us.

Spa Consultation Form

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