2011 Membership Application Spa_5_

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					                                                    Leading Spas of Canada
                                                              Membership Application – Spa

   Please complete the following form. You can easily navigate the form by using the ‘tab’ key. Fields in gray require
your input.

Spa memberships are available for 7 spa types including a developmental spa type. As members of this category,
all spas commit to following LSC’s Standards & Practices and Code of Ethics. Regardless of how your business
is marketed, if your business offers medical esthetic services, you must comply with LSC’s Medical Esthetics
Standards & Practices.

     This category of membership receives recognition on the LSC website. Exceptions as noted*
     Members may be invited to participate on LSC committees, will have voting rights, and principals of such
      members are eligible for election to the Board of Directors.
     Membership application is subject to LSC’s approval process.
     LSC reserves the right to decline application for membership.

    Leading Spas of Canada – Code of Ethics

1. Each member will be guided by truth, fairness, and integrity.
2. Each member agrees to support the ongoing improvement of quality and professional spa services offered to the
3. Each member agrees to act in a professional and responsible manner towards clients.
4. Each member agrees to support and positively promote the actions and establishments of each active member
   in good standing in an unbiased and non-judgmental manner.
5. Each member agrees to express their opinions, in any form of media, honestly and accurately without making
   any unfounded scientific allegations relating to therapeutic results that may be false or misleading.
6. Each member agrees to stay within their own area of competence and scope of professional practice. As a
   customer service function and where appropriate, a member may suggest to their clients that they might seek
   professional assistance elsewhere relating to any condition that is beyond the scope of the professional practice
   of the member.
7. Each member agrees to inform their clients of all payment policies, costs, &/or fee schedules prior to billing for
   any services rendered or products supplied.
8. Each member pledges loyalty to the association and agrees to pursue and support its objectives.

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 Leading Spas of Canada – Standards & Practices

Leading Spas of Canada has established the following Standards & Practices to ensure that all members of the
Association provide the highest level of professional services and products to the general public. By signing the
Verification Statement, all Association members agree to adhere to these Standards & Practices, and to the
Association’s Code of Ethics. As a Leading Spas of Canada member, you may be subject to a random inspection to
ensure that the professional levels of performance required by the Association are being maintained.

Furthermore, members pledge that their operating procedures and practices comply with all applicable local,
provincial and federal regulations, including those for persons with disabilities, and that all co-workers meet all local,
provincial and federal regulations with regards to licensing.

As Canada’s premier spa industry organization, Leading Spas of Canada continues to advocate for Government to
adopt these Standards and Practices.

Please note: If your business offers or provides medical services and regardless of how your business is
marketed (e.g., ‘Day’ Spa offering medical services), you must comply with LSC’s Medical Esthetics
Standards & Practices.


The spa and its coworkers will ensure that:
  All co workers follow appropriate hygienic standards at all times.
 The premises and all instruments used are appropriately sanitized and sterilized.
 A first aid kit is properly stocked and readily available at all times.
 A written emergency plan is posted in plain view at all appropriate staff locations. The plan includes standard
   emergency procedures for specific incidents and phone number for police, fire, and emergency medical
 All procedures for cleaning and maintenance are in accordance with federal, provincial, and local regulations,
   and with appropriate manufacturer’s guidelines.
 All floor surfaces are constructed to accommodate the intended activities for each area.
 Signage is posted to alert and educate guests about possible risks and practices, as needed, in such areas as:
   exercise studios, pools, wet areas, saunas, steam rooms, whirlpools, racquet sports courts and any other
   potentially hazardous area.
 Appropriate control of temperatures is ensured through an ongoing monitoring system in all areas where guests
   are exposed to high thermal stress, e.g. saunas, steam rooms, whirlpools and exercise rooms.
 Coworkers are available to provide assistance and instruction in the proper and effective use of fitness and
   weight training equipment.
 Coworkers who perform advanced techniques and/or use advanced technology are thoroughly trained and do so
   in compliance with the manufacturer’s instructions and guidelines.


You and your spa will ensure that:
 Coworkers, when hired, are provided with a Policy and Procedures Manual which is reviewed and updated
 Coworkers are provided with and/or given access to constantly updated Treatment Procedure and Product
   manuals for all treatment modalities included in the spa’s menu.
 Coworkers are given a job/responsibility description upon hiring, followed up with at least one annual evaluation
   of individual’s job performance.

                                                                                                                 Page 2 of 8
   All specialized/professional staff such as fitness instructors, personal trainers, massage therapists, estheticians,
    nail technicians, hair stylists, nutritionists, physiologists, psychologists and medical technicians complies with
    local, provincial and federal regulations with regards to licensing, registration and appropriate certification.
   The Director/Supervisor of any fitness program has at least a bachelor’s degree (or equivalent) in an appropriate
    area of study, or a current certification from a nationally recognized organization in the health/fitness industry.
   The spa will have at least one staff member who has CPR and First Aid certification, on site during operating
   Demonstrates a commitment to providing education, training and professional development opportunities for all


You and your coworkers will ensure that:
 Written material is provided that accurately depicts the facility, nutrition/diet/wellness and other programs,
   philosophy, rates, deposits, customary tipping and gratuities, cancellation policy and grace period for refunds.
 Guests complete a confidential screening questionnaire and/or informed consent statement appropriate to their
   planned activities.
 All guest history and counseling session information is considered private and confidential and it in compliance
   with privacy legislation. The spa or its coworkers without the proper consent of the individual do not disclose
   such information, unless law requires such a disclosure.
 All guest complaints are promptly responded to and resolved in as timely and efficiently a manner as possible.
 The spa has current liability insurance or the equivalent for the purpose of guests’ protection.
 All spas with fitness programs are flexible enough to accommodate a variety of goals, fitness levels, and needs.
 Spa programs and menus are designed to encourage the guest toward health enhancing activities and wellness
   while acknowledging the guest’s current health status.
 It is imperative for each member of LSC to communicate honestly in all marketing material and
   photographs/videos in order to deliver an authentic experience to spa consumers. This helps us manage
   expectations and builds trust. Spa consumers are constantly disappointed when photographed images used in
   marketing material and websites are not what they experienced as a paying Guest.


As coworkers, you will ensure that you:
 Are professional, courteous, helpful, knowledgeable, and articulate.
 Are committed to anticipating guests’ needs and serving them.
 Reflect the spa’s policies in appearance, attitude, and teamwork. Believe in the precepts of Spa Wellness and
    are willing and able to share these philosophies with guests.
 Agree in writing to abide by the Policies and Procedures established by the spa.
 Understand and follow your personal job descriptions.
 Demonstrate professional client management through the maintenance of client records on an ongoing basis.
 Zealously guard the guest’s privacy and modesty.
 Are committed to honoring the confidentiality of the spa and its business, in general.
 Adhere to the professional standards of hygiene as defined by the spa.
 Maintain all personal certifications as required by provincial or federal legislation.
 Take personal responsibility for your continuing professional development.
 Are attentive to preserving the Spa Environment at all times.

                                                                                                               Page 3 of 8
    Leading Spas of Canada – Medical Esthetics Standards & Practices

As spas increase in numbers and with the growth in the field of medical esthetics, there is an increasing trend for
medical esthetic procedures to be offered in spa facilities. There are many esthetic treatments that can easily be
performed in a non-medical facility. However, it is important for patient safety that medical standards are adhered to
in these facilities. The following are minimum standards that should be complied with for any non-medical facility
offering medical esthetic treatments.


In order to offer a safe treatment the facility must:
 Have a private treatment room for the practitioner and patient.
 Have a sink for hand washing with hand sanitizer in each treatment room.
 Have a sharps disposal container for injectable biomedical waste.
 Provide clean linens or similar material for treatment chair/bed for each patient.
 Provide a contact number to patients for any follow up or complications.
 Maintain a clean treatment room.


     Must be a licensed medical doctor with valid College of Physicians and Surgeons Registration for the province in
      which treatments are offered. The physician must also be a current member of the Canadian Medical Protective
      Association and have informed the CMPA in writing of their provision of the medical esthetic procedures.


     A registered nurse with valid registration with the Nursing Association for the province in which treatments are
      offered. For nurses providing services, a licensed medical doctor with valid College of Physician and Surgeons
      registration must supervise the procedures.


     The practitioner must wash or sanitize hands prior to any medical esthetic treatment
     For any injectable treatment:
       The practitioner must wear gloves.
       Sterile needles, syringes and products must be used.
       All needles and any expired injectable product must be disposed of in a biohazard container, which is
          removed by a biomedical waste disposal service.
     For Botox treatments:
       Unused Botox must be stored in a refrigerator at a temperature of 2 to 8 degrees C or in a freezer at a
          temperature of -5 degrees C or less.
       Botox must be reconstituted in a sterile manner with sterile normal saline.
       Reconstituted Botox must be stored in a refrigerator at a temperature of 2 to 8 degrees.


     Before commencing a medical esthetics procedure, a practitioner must:
       Determine contraindications for treatment.
       Describe to the patient the proposed treatment and the risks of the procedure.

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      Answer any questions from the patient concerning the proposed treatment.
      Obtain a written consent from the patient to provide the proposed treatment.
   The practitioner must maintain confidentiality of all patient information.
   The practitioner should provide clear instructions for follow up care and contact information for any
    complications, preferably in a written format.


   There must be an indelible clinical record for each patient which documents:
     The patient’s name, address, phone number and birth date.
     The date of each treatment provided and the name of the practitioner providing treatment.
     Health history.
     Treatment notes documenting the treatment provided, area treated, quantity/settings used in treatment and,
         if applicable, the lot number of product used.
     Any complications of the treatment must be recorded in the patient chart.
   The health care records must remain in the spa facility until it is necessary to destroy or transfer the record.
   All medical files must be filed separately from spa records.
   The record should be retained in a safe and secure place for at least 10 years after the date of the last treatment
    entered in the patient’s record. Medical files must be kept separately from spa treatment records.
   If the applicable retention period has passed and a facility elects to dispose of a health care record, it may do so
    by destroying the physical record by utilizing a paper shredder or by complete burning of the record.

                                                                                                               Page 5 of 8
Types of Membership (review and select appropriate type)              Select a Spa Type

 Please note: If your business offers or provides medical services and regardless of how your business is
marketed (e.g., ‘Day’ Spa offering any medical services), you must comply with the Standards & Practices for
                                             Medical Esthetics.
Day Spa                    A spa providing a service menu with a variety of therapeutic, relaxing and pampering
                           treatments on a day-use only basis. The day spa menu typically includes European
                           esthetics, paramedical services, therapeutic body massage, body, hand and foot
                           treatments. In some instances, hair services may also be available.
Destination Spa            A spa whose sole purpose is to provide guests with lifestyle improvement and health
                           enhancement through professionally administered spa services, physical fitness,
                           educational programming, and on-site accommodations and spa cuisine is served.

Resort, Hotel or Inn Spa   A spa located within a Resort, Hotel, or Inn providing a variety of spa services, fitness and
                           wellness components and spa cuisine menu choices. Exclusive properties may restrict
                           access to the spa to overnight guests. Resort, Hotel, or Inn spas may also be available to
                           day spa guests from the local community.
Integrated Health Spa      A spa offering services integrating traditional, alternative and complementary holistic and
                           advanced holistic therapies in conjunction with European esthetics, massage, body and
                           water therapies. Services may include medical and complementary medical services,
                           acupuncture, detoxification, homeopathy, nutrition, and personalized supplementation,
                           Yoga, Tai Chi, meditation classes. Specialist practitioners may include doctors, nurses,
                           naturopaths, homeopaths, Traditional Chinese Medicine, Reiki practitioners, for example.
Medical Spa                A spa or institution that operates under the supervision of a licensed health care
                           professional. Medical professionals, physicians and spa professionals whose primary
                           purpose is to provide comprehensive wellness care and/or medical esthetics in an
                           environment that integrates traditional western, complementary, and alternative
                           conventional therapies and treatments, provide services. Services may also include
                           aesthetic/cosmetic and prevention/wellness procedures. Treatments for weight loss, anti-
                           aging skin care therapies and laser hair removal are among the innovative services offered
                           at the medical spa. Medical spas may or may not have overnight accommodations. A
                           copy of your physician’s license is required with this application (a digital copy is
                           acceptable, or a copy may be faxed.).
Mineral / Thermal Spa      A property offering natural mineral, thermal or sea water, sometimes used in conjunction
                           with cold water for the purpose of hydrotherapy treatments. Treatments use physical
                           water properties, such as temperature and pressure, for therapeutic purposes, to stimulate
                           blood circulation and treat the symptoms of certain diseases. This type of spa often
                           incorporates sauna and steam services.
Developmental Spa *        A spa in development, not yet open for business, or not meeting the requirements of the
                           primary membership categories. A spa in this category is expected to open within a year
                           of being approved in this category
                           *This category of membership has no voting rights, and such members are ineligible for election to the
                           Board of Directors. Such members will not be listed on the Leading Spas of Canada website until they
                           meet the Association Standards & Practices.

                                                                                                                      Page 6 of 8
   Tell us about you and your business. Please complete the Survey, Tell Us More! Kindly provide the details
about what makes your spa unique as well as the service(s) and product(s) you provide. If your business provides
medical services, please ensure full review and acceptance of LSC’s Medical Esthetics Standards and

 Terms & Conditions

    Payment must be received immediately to confirm membership.
     Please ensure that requirements of membership are met by carefully reviewing the spa type
     descriptions, Standards & Practices, Code of Ethics, and providing the requested verification
     documentation. Please return completed, dated, and signed application, with copies of required
     supporting credentials. Membership approval will only commence upon receipt of all required
     documentation with full payment.
    Membership applications are screened in accordance with Leading Spas of Canada Standards
     & Practices and Code of Ethics.
    It is the responsibility of the spa business to advise Leading Spas of Canada when it
     implements new products &/or services that change its approved spa type within the spa
     membership category. Failure to advise LSC of significant changes affecting spa type may
     result in membership being revoked with membership fees being non-refundable. To ensure
     quality standards are maintained within the LSC membership, compliance is monitored
     through periodic, and random checks.

 I have read and understand the obligations of membership with LSC and confirm that by
 submitting this application, I am committed to fulfilling all obligations and commitments as

       On-line registration, please Check Here to acknowledge and accept Terms & Conditions.
 If the form has been downloaded and printed, please sign below.

 Signature                                                      Name (Please Print)

                                                                                                        Page 7 of 8
 Contact Information - Company information will be published in LSC’s printed directory, contact name and information will be
 available on-line.
 Company Name                                                           Email
 Phone                                                                  Fax
 Address                                                                City
 Province                                                               Postal Code
 Primary Contact                                                        Primary Email
 Marketing Contact                                                      Marketing Email
 Accounting Contact                                                     Accounting Email
 Website Address                                                        Facebook Name
 Twitter Name                @

 Pricing & Payment Information
                                                                              Jan 1 – Dec 31

        2011 Annual Membership Spa                                            $ 600.00**                     $
                                                                              Subtotal                       $
 **Please include applicable tax for your province                            GST/HST                   %    $
                                                                              Total                          $

 Payment Method             VISA/MC           CHEQUE ENCLOSED
 Card #                                                                        Expiry Date
 Name on Card                                                                  Today’s Date

 Next Steps
Once your completed application is received, LSC will send an email confirmation. Approximately one week after your application
is received, LSC will forward via email, confirmation of approval and a user name and password for your website profile. Logon to
the members’ only area and post your company information for the online listing. In another 4-6 weeks, your membership
welcome kit will be forwarded by mail. The kit will include a guide to member’s benefits as well as a Leading Spas of Canada
Membership Certificate & Verification decal.

 Contact Leading Spas

Leading Spas of Canada
Box 157, Sooke, B.C. V9Z 0P7
T Toll Free 1.800 704.6393
F Toll Free 1.877.423.1799

                                     Thank you for your application!

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