978-650-2895 | 978-244-0300

3 Littleton Rd Unit 1 | Westford, MA 01886
Westford/Chelmsford Line
(Formerly Of Chelmsford)

Please check Appointment Guidelines link before coming to your appointment it will help you understand the new procedures we need to follow.

A Spa to Remember Ion Cleanse Release Form

* Required

    First and Last Name*

    Date of birth*




    Zip Code*

    Phone Number*

    Email Address*

    Would you like to receive weekly text messages of our specials?*

    Do you wear a pace maker or any other battery operates or electrical implants?*

    Are you on a heartbeat regulating medication?*

    Are you an organ transplant recipient or donor? *

    Are you taking – blood pressure medication, seizure medication or depression medication?*

    Are you pregnant?*

    Are you lactating and/or nursing? *

    Have you Eaten? *

    Because our bodies are approximately 70% water, we ourselves interact with this field (Ion Cleanse).
    The toxins in our bodies will look similar to the toxins predominant in a specific area; however, there
    will be more toxic particles in the water with the client’s feet immersed.

    "Healthy individuals can expect to feel lighter and experience a greater feeling of well being from each Ion Cleanse Session. Some people with pain, edema, and swollen or deteriorating joints have reported symptomatic relief from the Ion Cleanse sessions."

    The Ion Cleanse helps your body to start a detox process and during that process you need to give your body a chance to re-calibrate from the shift in torte load.

    Rest is important in healing.
    Nutrition is important in healing.
    Water Consumption is important in healing.
    Ability of the body to eliminate toxic load is important in healing.

    Also, it is IMPORTANT that you are eating a balanced, nutritional diet, fresh foots, drinking plenty of fluid and taking the appropriate supplements to support your unique physical and psychological needs. Remember detoxification accelerates changes in the body and healthy lifestyle choices will support this process.

    Payment Information

    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*

    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.

    Are you on Instagram? Follow us! @aspatorememberwestford