Serenity Wellness LLC
Serenity  Wellness LLC

Intake

Please fill out the information below before you call to schedule. This is for your safety as some services may be contraindicated conditions.  

 

*** You must fill out your own intake.  Someone else may type your answers for you but you must answer the questions yourself. 

 

PA law requires Electronic Health records.   Once you complete the form, call us at 610-565-6627 to review the information.  We are happy to schedule you once this is completed. Please do not skip any questions as you will need to start all over again. This is the basic information needed to schedule your service. You will have a longer intake to fill out your day of service.   

 

If you have a voucher/gift card please have this information with you to fill into the intake form. We will also need a Credit card or Debit card to schedule you.   

 

 

 

 

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Office Policies

 

Cancellation

 

We require a 48 hour notice for all cancellations and rescheduling.

Please call 610-565-6627  to cancel all appointments. You may leave a msg if after hours or if we are busy helping other clients 

 

Cancellations less than 48 hours or No shows will be charged 100% of the full service charge as we do not have time to schedule another client  in your place.  You may gift your appointment to another person, just have them fill out the intake form above, tell them about the gratuity and where to park and give us a quick call to tell us who wil be taking your place. We charge $1 to your credit or debit card in order to reserve your appointment. This is to ensure this is an active card. We will use this card to charge your cancellation fee when not given proper cancellation notice.  You may either have this $1 refunded at the time of your appoimnet or we will donate it along with all other reservation fees to charity at the end of the year.   ( Groupon clients are charged $39 for European facials and Dermalogica facials,  $59 for Chocolate cherry rose or Enzyme facials, 60 minute Therapeutic plus and Deep tissue plus massages. You will however retain your Groupon certificate to reschedule) 

 

Gift certificate clients will forfeit their gift certificate.

 

We recommend you have a sitter in place in case your child is sick as we can not reschedule due to child home from school. We also can not reschedule when you are called in to work. We are happy to reschedule when you give us 48 hours cancellation notice. 

 

On rare occasions we may wave the fee, however this is on a case by case basis.  We must be strict with our policy as we have reserved this time just for you and cannot fill the slot without proper notice.

Our time is valuable please respect us by giving time to fill your appointment slot.  

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 Cancellations before 48 hours my be rescheduled with no cancellation fee.

 

 

Weather Emergencies

 

In case of snow emergency, tornados, power outages etc, the facility will be closed for our safety and yours. No fee will be charged in dangerous conditons.    We post our closings on our facebook site, Serenity Wellness Center  

 

Gratuity

 

By scheduling this service, you acknowledge gratuity is not included in the price of the  service.   You agree to bring cash for gratuity as we cannot accept credit or debit cards for gratuity.  Standard gratuity is 15-25% or more of the pre-discounted service price.  Please be generous with your therapist when earned.  You agree to tell us if service is lacking in any way, as we rely on your feedback so that we may constantly improve services. Our receptionist will give you standard Gratuity suggestions based on the original pre- discounted price.  We also have a chart available for your convenience.

 

Lateness

 

if you are late, you may not be able to receive my full appointment time.  However you will still be charged for the scheduled service in full.  

 

Testimonials

 

If you chose to give a written or video testimonial or review, we reserve the right to use that testimonial /review in advertisement and or marketing.

 

Refunds

 

We do not allow refunds on gift certificate purchases, product purchases or appointments scheduled and not canceled within standard 48 hours cancellation notice

 

Release

 

By completing this intake and scheduling with Serenity Wellness LLC you agree that you have read and agree to abide by the following terms and conditions of all services at Serenity Wellness LLC DBA Serenity Massage & Spa, Serenity Counseling & Wellness:

 

I agree that I have filled out all information truthfully and fully, understanding that for some medical/psychological conditions and symptoms, treatments may be contraindicated.

 

All of the information I have provided is accurate and complete to the best of my knowledge. I take responsibility for alerting my technician of any changes to my health status, medications or treatments or treatments before each session.

 

I acknowledge that the practice of all treatments provided at Serenity Wellness LLC are not an exact science and no specific guarantees can or have been made concerning expected results.

 

If I experience pain or discomfort during any session, I will immediately inform the therapist so that they may adjust to my level of comfort or adjust treatment provided.

 

I further understand that all treatments provided by Serenity Wellness LLC should not be construed as a substitute for medical examination, diagnosis or treatment and that I should see a physician, chiropractor, psychiatrist, dermatologist, or other qualified medical specialist for any mental or physical ailment that I am aware of.

 

I understand therapists are not qualified to perform spinal or skeletal adjustments, diagnose, prescribe, or treat any physical or mental illness and that nothing said in the course of sessions given should be construed as such.

 

I also agree to hold harmless Serenity Wellness LLC as well as any officers, employees, or contractors of the above company for any condition or result, known or unknown, that may arise as a result of any treatment that I receive today and in the future.

 

 

Children and pets

 

Registered Service dogs are always welcome but we cannot have you bring your other non- service pets.  Unfortunatley we can not accommodate small children , infants, toddlers etc.  For their safety and the comfort of other guests receiving treatments, please arrange for a sitter at home.

 

 

Parking & Location

 

We are located at 349 W. Baltimore Ave in Media PA on the corner of Baltimore Ave and Lemon Street, diagnonal from Hill's Seafood. We are in the little town of Media.  If traveling south, we are at the end of Media on the right hand side.  We are the last building in the block with the Wine and Spirts store.  If you go down a very steep curved hill on the way to the Granite Run mall you have gone too far.    If traveling North, from Granite Run, you will pass the Sterling Pig on the left and we are at the crest of the hill, on the left hand side.   

 

YOU MAY PARK IN ANY OF THE SPOTS MARKED 349 TENANT PARKING ONLY.

 

BE AWARE GPS WILL OFTEN TAKE YOU TO 349 W. BALTIMORE PIKE.  THIS IS THE WRONG ADDRESS!

 

 

Privacy and HIPPA

HIPPA Privacy Authorization Form **Authorization for Use or Disclosure of Protected Health Information (Required by the Health Insurance Portability and Accountability Act, 45 C.F.R. Parts 160 and 164)**

 

**1. Authorization**

 

I authorize Serenity Wellness LLC  to share  my protected health information with my therapist .  I recognize a call center may be utilized to review my information and or a front desk person may review this information for purposes of scheduling.  Unless otherwise noted,  my information shared is to remain private and not shared unless I give explicit written permission. 

 

 **2. Effective Period** This authorization for release of information covers the period of healthcare for all past, present, and future services.

 

**3. Extent of Authorization** The limits to my privacy shall not supercede the law.  ( Ex, Therapist is legally required to report child abuse, elder abuse etc.)

 

** 4.  Written Release of Information is required for my therapist to share my personal information with outside parties.  Example, coordination of care with your doctor,or lawyer for  auto or wkers cases.)

 

 

 

Please call us at 610-565-6627 or email us at info@serenitywellnessllc.com if you have any questions regarding the above office policies.  Thank you, Serenity Wellness LLC management.

 

 

** By scheduling you agree to all the above office policies/procedures.

 

Schedule An Appointment:  

Please complete our Intake form before calling to schedule

 

 

*** We have First Time client specials.   Please call us before Booking on line.  

 

 

Serenity Wellness Center
Street Level
349 W. Baltimore Ave
Media , PA 19063
Phone: 610 565 6627 610 565 6627
Fax:
E-mail Address:

Center Hours

Please call ahead for product pickup or scheduling.

We are a small facility and are open by appointment: 

 

Below are our hours available for scheduling. 

 

Please note Saturdays are for Special events, girls day out parties, festivals and emergency appointments only.  

 

 

Mon 1:00 PM to 7PM
Tues 10:00AM to 7:00PM
Weds 10:00AM to 7:00PM
Thurs 10:00AM to 7:00PM
Fri 10:00AM to 4:00PM
Satur Closed 
Sun Closed



 

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