You can always press Enter⏎ to continue
Recurring Massage Formm
Please complete this form based on your preferences for you recurring massage appointment. Our Wellness Manager will reach out with a suitable appointment.
12
Questions
START
HIPAA
Compliance
1
Name
*
This field is required.
First Name
Last Name
Previous
Next
Submit
Press
Enter
2
Phone Number
Area Code
Phone Number
Previous
Next
Submit
Press
Enter
3
Email
*
This field is required.
example@example.com
Previous
Next
Submit
Press
Enter
4
Do you have an account with Down Under Yoga?
If you do not, please make one by visiting downunderyoga.com. Please include your credit card and sign the liability waiver. This will allow the Wellness Director to book your recurring appointments.
YES
NO
Previous
Next
Submit
Press
Enter
5
Which Massage Therapist would you like to see for your recurring appointment?
*
This field is required.
Ann Appavoo (Master Therapist) (Brookline)
Rika Allien (Master Therapist) (Newton)
Charles Faris (Brookline)
Paul D'Agostino (Brookline)
Rich Nadeau (Brookline/ Newton)
Mukul Bhatt (Brookline)
Andre Villon (Harvard Square)
Lashea Williams (Back Bay)
Becca Phillips (Back Bay)
Steven Rodriguez (Boston South End)
Maryella Robinson (Harvard Square)
No preference
Not listed- (Please use notes below to specify)
No preference
×
Ann Appavoo (Master Therapist) (Brookline)
Rika Allien (Master Therapist) (Newton)
Charles Faris (Brookline)
Paul D'Agostino (Brookline)
Rich Nadeau (Brookline/ Newton)
Mukul Bhatt (Brookline)
Andre Villon (Harvard Square)
Lashea Williams (Back Bay)
Becca Phillips (Back Bay)
Steven Rodriguez (Boston South End)
Maryella Robinson (Harvard Square)
No preference
Not listed- (Please use notes below to specify)
Previous
Next
Submit
Press
Enter
6
Which location would you like to visit for your recurring appointments?
You may only select one option.
Boston South End
Cambridge Harvard Square
Brookline
Newton
No Preference
Boston Back Bay
Previous
Next
Submit
Press
Enter
7
What frequency of recurring massage appointments would you like?
Appointments are scheduled on the same day and time on a recurring basis. If you select a weekly appointment, you appointment will be every week. If you select bi- monthly your appointment will
not
be every other week, but instead will occur two times per month. For example, on the first and third Friday of the month or on the second and forth Friday of the month. If you select monthly your appointment will occur one time per month, for example on the third Monday of every month.
Weekly
Bi-Monthly (twice per month)
Monthly (once per month)
Previous
Next
Submit
Press
Enter
8
What frequency of appointments would you like?
*
This field is required.
Appointments are scheduled on the same day and time on a recurring basis. If you select a weekly appointment, you appointment will be every week. If you select bi- monthly your appointment will
not
be every other week, but instead will occur two times per month. For example either on the first and third Friday of the month or on the second and forth Friday of the month. If you select monthly your appointment will occur one time per month, for example on the third Monday of every month.
Weekly
Bi- Monthly
Monthly
Previous
Next
Submit
Press
Enter
9
What length of appointment would you like?
*
This field is required.
60 mins ($85) (Senior Therapist $95)
75 mins ($100) (Senior Therapist $110)
90 mins ($110) (Senior Therapist $120)
120 mins ($150) (Senior Therapist $160) *Not available with all therapists
Previous
Next
Submit
Press
Enter
10
Are you able to commit to 6 appointments scheduled on the same day and time on a recurring schedule?
*
This field is required.
*You are able to reschedule or skip 1 massage per every 6 booked. Recurring massage offers the best price for your massage. If you cannot commit please book drop in one time massage appointments or purchase our discounted 4 pack.
YES
NO
Previous
Next
Submit
Press
Enter
11
Please provide 3 convenient days of the week and times for your recurring appointment.
*
This field is required.
Huge
Large
Normal
Small
Ok
quote
Created with Sketch.
Ok
Previous
Next
Submit
Press
Enter
12
Please provide 2-3 convenient days and times for your recurring appointment.
Previous
Next
Submit
Press
Enter
13
Do you accept the Terms and Conditions?
*
This field is required.
Terms and Conditions: Cancellation must be made at least 24 hours prior to the appointment to receive an account credit; account credit does not expire and can be used towards any future purchase with Down Under.
Cancellations within 24 hours of the appointment will result in no refund to either the account or card on file.
For recurring appointments: The appointment payment will be processed up to 1 week prior to your appointment using the card on file in MindBody. An email receipt will automatically be sent upon processing.
YES
NO
Previous
Next
Submit
Press
Enter
14
Are there any additional considerations or questions you would like to add?
Huge
Large
Normal
Small
Ok
quote
Created with Sketch.
Ok
Previous
Next
Submit
Press
Enter
Should be Empty:
Question Label
1
of
14
See All
Go Back
Submit