Massage Appointment Request Form

Massage Appointment Request

Appointment is not scheduled until you receive confirmation of date and time from Amanda.
Full Name*

First NameLast NameSuffix
Contact Number*
Please enter a valid phone number.
Email Address*
example@example.com
Fill in your date/time request below, and Amanda will let you know if she has it available!

Massage appointments are generally available Monday through Friday between 8:00 AM and 3:00 PM and Saturday between 7:00 and 11:30 AM. If you need a day/time outside these hours, submit your request, and Amanda will get back to you!

If your request is for a date within the next 3 days, please call or text Amanda instead at (402)880-4846.
What date and time would work best for you?

MonthDayYear
Date
Time MinutesAM/PM Option
Secondary date and time preferred, if the above selection is not available.

MonthDayYear
Date
Time AM/PM Option
Do you need to request a date and time outside usual hours?

MonthDayYear
Date
Time AM/PM Option
What type of massage would you like to schedule?
Any additional information you'd like to share or questions you have for Amanda?
Should be Empty: