spa hotel Limerick voya

No. 1 Pregnancy Treatment Consultation Form

We require you to complete this online consultation form prior to your spa visit to ensure that we take really good care of you during this delicate time and that your spa experience and treatment meets your specific needs.


    Personal Details

    Your Name

    Your Address

    Contact Number

    Email Address

    Please Select Below

    Date of Treatment
    Please Select Below

    Doctors/ Gynaecologists Information

    Doctor's Name

    Doctor's Contact Number

    Doctor's Email Address

    Pregnancy Related Health Information

    How many weeks pregnant are you?

    Are you currently experiencing any of the below symptoms?
    Please Select Below

    Please specify any other relevant health information below

    Do you have any other specific requests or requirements?