Please provide the following details so we can help book your session:

Days/Dates you had in mind:
Preferred Start Time window range: (please note if firm start time)
Duration: hours

The appointment is for: myself my spouse / significant other couples- my partner & I guests at my event my work associate(s) my employees my daughter my son my mother father my other relative --------------------- spa party- daughter & friends my friend my patient my boss my business client(s)

Are you seeking to purchase a Gift Certificate for in-home Therapeutic Massage for someone else?

If inquiring about an event of any type or corporate chair massage: What is the approximate number of people who will be seeking services (employees or guests)?

If at a venue: What is the name of the place?

Street address:

City or Township:

Business suite, apartment, or hotel room number (if applicable):

Floor number:

If on a higher floor, therapist may use the: (please check all that apply)
Elevator  Stairs  Ramps 

The planned location is a(n): (please check all that apply)
House  Apartment  Condo  Townhouse 
Gated Community  Hotel  Office  College Dorm  Restaurant  Party Venue  Building Commons Area 

Parking for therapist: (please check all that apply)
Street Parking, Free  Park in Driveway  Must Get Guest Parking Pass 
Park in Lot  Paid Parking Only 

Planned method of payment: Cash Credit Card Google Pay Cash App PayPal eCheck Money Order Gift Certificate Gift Card Personal Cheque Bank Cheque Venmo USD Coin Bitcoin Dogecoin

If you're having an event: What type of event is it?

For corporate wellness and chair massage inquiries: Might this become a regularly scheduled appointment if this works out well?

For in-home sessions: Are you potentially interested in purchasing a package of sessions at a lower cost if you find the first session to be to your liking?

FOR OFFICE USE (DO NOT CHANGE) [HOME] ADDRESS:
FOR OFFICE USE (DO NOT CHANGE) [HOME] ID CODE: