The Mayflower Inn & Spa

We encourage you to complete the Blue Heron Insights with your personal spa advisor on the phone. You may, of course, choose to complete them on your own, in which case we ask that you offer as much detail as possible.

These Insights were designed to inspire you to focus on and clarify your needs and desires. Your responses will optimize our ability to design the most satisfying spa experience—one that will bring you joy and be effective and rewarding in lasting ways.

Please fill out either the online version below or download the PDF version of the Blue Heron form and fax or mail it back to us.

Our mailing address is:
PO Box 1288, Washington, CT 06793

And our facsimile is:
860-868-1497

Name
Dates of stay
Some sizes:
T-shirt	XS S M L XL
Pant	S M L XL
Pant Length	Reg. (29”) or Tall (32”)
Shoe

How may we contact you?
Email
Telephone
Fax
Mail
What is the best time of day to contact you?

Your Health
Are there any medical concerns you might have that could restrict the activities we could schedule for you?
Yes No
If yes, what are they?
Is there any chance that you might be pregnant?
Yes No
Please describe any past or present injuries that could restrict that could restrict activites we schedule for you:
neck knee back	shoulder blood pressure other:

Your Expectations (Please check as many as are relevant)
Have you ever been to a destination spa before?
Yes No
If so, please describe a few things that you liked most and least about that experience.

What is your biggest motivation for having chosen a destination spa experience at this time?
Stress Fitness level Nutritional concerns	Sleep concerns Weight concerns Other
Would you prefer:	a very scheduled day a day with time open for rest and relaxation

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