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CONTACT US
Under Construction
CONTACT US
Therapeutic Massage
Please fill out the following survey before your massage session
Name
*
First Name
Last Name
Email Address
*
Phone Number
*
(This will forever remain private and secure)
Birthday
How often do you receive massage treatments?
Massage Type
Please indicate which type of massage you prefer for this session:
Relaxing/Gentle/Sweedish
Deep Tissue
Sports Massage
Assisted Stretching
Lymphatic Draininge w/Dry Brushing ($25 fee) Client will receive a dry brush to take home after the session.
Pressure
Please check which type of pressure you prefer:
Light Pressure
Medium Pressure
Hard Pressure
Massage Add-Ons
Please check any massage add-ons that you would like to include in your treatment session:
Aromatherapy
Cupping
Injuries
Please indicate if you have any injuries and/or areas that you prefer NOT to be massaged:
Focal Areas
Please indicate if there are specific areas of your body you would like the masseuse to focus on:
Neck and Shoulders
Low Back
Arms
Quadriceps (Front of the Legs)
Hamstrings and Gluteals
Face
Thoracic Spine (Middle Back/Shoulder Blades)
Hands/Feet
Thank you
