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Menu
Stay
Rooms
Corporate Stays
Gallery
Things to do
Offers
Food & Drink
Afternoon Tea
Press
The Hangout
Sample Menus
Wine and Cocktails
Spa
Spa Days
Spa Treatments
Spa Breaks
Health Club
Membership
Zionic
Golf
Green Fees and Tee Times
Access To Golf Scheme
Golf Breaks
Corporate Golf
Society Days
Course Map
Pro Shop
Safeguarding
The Bunker
Meetings
Conference Rooms
Delegate Packages
Team Building
Private Celebrations
Make an Enquiry
Weddings
Reception and Ceremonies
Options
Gallery
Contact
Directions
Lead name
*
Date of visit
*
First name
*
Surname
*
Address
Telephone
*
Mobile number
Email
*
Are you taking any medication?
*
Please select an option
Yes
No
If yes, please provide brief details
Pre-existing conditions
Stroke/DVT
Dizziness/fainting
Raised cholesterol
High/low blood pressure
Diabetes
Stomach ulcer
Claustrophobia
Liver or kidney problems
Epilepsy
Cancer
Heart condition
Asthma/ lung condition
Muscular pain
Verruca
Coldsore
Thyroid problems
Allergy
Fungal infection
Eczema/Psoriasis/Skin condition
Arthritis/rheumatism
Back problems
Headaches
Varicose veins
IBS/bowel condition
Other
Are you pregnant or breastfeeding?
Please select an option
Yes
No
Condition details
Other medical conditions
What is your stress level?
Please select an option
Low
Medium
High
Sleep quality
Please select an option
Deep
Light
Disturbed
How many days a week do you exercise?
Please select an option
Never
1-3
4-7
Do you smoke?
Please select an option
Yes
No
I understand that treatments are only suitable for over 18s unless stated otherwise.
Treatment disclaimer
*
I understand that Donnington Valley Health Club and Spa have a 24 hour cancellation policy on all treatments and Spa Days. If I do not give 24 hours notice of my cancellation, I will be charged in full.
Treatment cancellation policy
*
I accept that Donnington Valley Health Club and Spa will not be held responsible for any injuries sustained through misuse of the gym and weight equipment.
Gym disclaimer
*
I understand that I can have a gym induction with a qualified gym instructor if I wish and I need to book this in advance.
Gym disclaimer
*
I understand that the pool is not supervised by a lifeguard, and so I swim at my own risk.
Pool disclaimer
*
Submit