Online reservation requests – Summer 2020

Client information

Is this your first visit at BALNEA réserve thermale ? *
YesNo

Reservation details

For which date would you like to make a reservation for a massage ? *
^{(Reservation required in advance. Places are limited).}

For how many people would you like to make a reservation ? *
1 person2 people

In which timetable segment would you like to receive your massage ? *
Between 10 AM and 2 PMBetween 2 PM and 5 PM

If you want a massage, what type of massage do you prefer ?
RelaxationTherapeuticSwedishCalifornianSportifLymphatic drainageBALNEABALNEA gourmand

If you want a beauty treatment, what kind of treatment do you prefer ?
FacialScrubBody wrapSpa-pedicure

Do you have a preference for a male or female therapist ? *
NoYes, I prefer a man.Yes, I prefer a woman.

What is the best time to contact you ?
^{(Ex. After 5PM)}

PREVENTIVE MEASURES

Have you traveled out of the country in the last 15 days? *
YesNo

Have you been in contact with anyone who's traveled out of the country in the last 15 days ? *
YesNo

Have you been in contact with anyone infected with COVID-19 in the last two weeks ? *
YesNo

Do you have any of the following symptoms: *
CoughColdFluFeverSeasonal infectionsPneumoniaDifficulty breathingSudden loss of smell without nasal congestion or loss of tasteNo symptoms

If so, have you seen a doctor ?
YesNo

Are you experiencing any of the following symptoms unrelated to a known cause ? *
^{(Ex. Arthritis, allergies, recent injuries)}
Sore throatHeadacheMuscle achesSevere fatigueRunny noseSignificant loss of appetiteDiarrheaNo symptoms