Gift Certificate Order Form
Thanks for your interest in purchasing a gift certificate! PLEASE NOTE - Our practice typically books 1-2 weeks out; sometimes further for evenings/weekends. Recipients are encouraged to schedule appointments in advance. Please complete the below information; our front desk staff will "B In Touch" as soon as we can!
*
Your first name
Last Name
*
Your Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
*
Your email address
-
Your phone number (area code in first box)
Who is this certificate for?
*
First Name
Last Name
Where/how would you like this gift certificate sent?
*
Emailed to me
Emailed directly to the recipient
Hard copy mailed to me
Hard copy mailed directly to the recipient
I'll pick it up at your (Needham) location
No certificate needs to be sent; please keep this purchase on file
Please provide an email address or mailing address for shipping (if no certificate is needed, skip this step):
If emailing or mailing, when would you like it sent? (If you plan to pick it up, you can skip this question)
ASAP
Sometime in the next day or two
Other
To:
From:
Message:
Any additional notes or requests? Please enter them below:
Please choose from the items below. Flat amount options and optional gratuity can be found below our service options.
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15-MINUTE CHAIR MASSAGE
$
35.00
Quantity
1
2
3
4
5
6
7
8
9
10
30-MINUTE SESSION
$
75.00
Quantity
1
2
3
4
5
6
7
8
9
10
Item subtotal:
$
0.00
45-MINUTE SESSION
$
100.00
Quantity
1
2
3
4
5
6
7
8
9
10
Item subtotal:
$
0.00
60-MINUTE SESSION
$
120.00
Quantity
1
2
3
4
5
6
7
8
9
10
Item subtotal:
$
0.00
75-MINUTE SESSION
$
140.00
Quantity
1
2
3
4
5
6
7
8
9
10
Item subtotal:
$
0.00
90-MINUTE SESSION
$
160.00
Quantity
1
2
3
4
5
6
7
8
9
10
Item subtotal:
$
0.00
SPECIALTY MASSAGE UPGRADE
$
25.00
Active Release Therapy (ART), Ashiatsu, Cupping, Hot Stone, or Prenatal treatments (60+ minute sessions only)
Quantity
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
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18
19
20
Type of upgrade
Mix & match / Not Sure
Active Release Therapy (ART)
Ashiatsu
Cupping
Hot Stone
PreNatal
Item subtotal:
$
0.00
Flat Amount
$
50.00
Flat Amount
$
100.00
Flat amount
$
250.00
Flat amount
$
500.00
Flat amount
$
750.00
Flat amount
$
1,000.00
Gratuity
$
15.00
Quantity
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Item subtotal:
$
0.00
Gratuity
$
20.00
Quantity
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Item subtotal:
$
0.00
Gratuity
$
25.00
Quantity
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Item subtotal:
$
0.00
Gratuity
$
30.00
Quantity
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Item subtotal:
$
0.00
Gratuity
$
35.00
Quantity
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Gratuity
$
40.00
Total
$
0.00
Payment Methods
Credit Card
Apple Pay
After submitting the form, you will be redirected to Apple Pay to complete the payment.
Submit
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