Request an Appointment

Company

*Only needed for office accounts

First:

Last:

Address:

Unit #:

City:

State:

Zip:

Home Phone

Work Phone

Mobile Phone

E-Mail

Requested Date:

Start Time:

End Time:

Requested Therapy:

Requested Therapist:

Have you used our service before?

Yes No

How did you hear about us?

What are your goals for this therapy?

Client agrees to complete a Client Intake Form prior to the start of their massage appointment. It is important that we know your medical history prior to treatment. This will help serve you and your health to the best of our capabilities.

Client agrees to be ready for treatment on scheduled appointment time. Treatment time will end as scheduled.

Client agrees to pay full treatment cost for booked time if starting time begins late due to his/her tardiness. Your therapist will arrive 15 minutes early to complete all necessary paper work and set up his/her equipment.

Client agrees to leave genitals, buttocks & breasts covered at all times. Though we understand many people are comfortable with nudity, it is against the law with respects to our profession. It also compromises the comfort level of our therapists. Our therapists reserve the right to end any session that compromises their comfort level or sense of safety and the client agrees to remit full payment for scheduled treatment.

Client agrees to pay a 50% charge of the appointment fee for cancellations given with less than 24 hours notice. A 100% appointment fee will be charged if less than 4 hours cancellation notice is provided. Our therapist's time is valuable and we appreciate your co-operation with this policy.

By clicking 'submit' you acknowledge that you have read and understand the policies as outlined above.

Once your massage appointment request has been submitted, you will receive a follow-up call from our office to complete and confirm your requested appointment.