804-837-4292 | email@example.com | www.vhm.massagetherapy.com
Important: Please only complete this form if there are no available appointments that work with your schedule after you've looked online. Please note, that if you are a new client, you will be required to complete our intake form. We will notify you if there is a cancellation or if there becomes an open appointment for the day your looking for.
Client Full Name:
Age and Birthdate: (Please us MM/DD/YYYY format)
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Please leave any comments or questions here for the therapist? Please let us know if you are seeking massage for relaxation, a specific pain issue, recovery from a injury, mobility/flexibility, stress/anxiety?
Please visit our website at: www.vitalityhealthmassage.com to review our policies. By completing this form you agree to all of our policies.
Topics or policies to review with clients.
Yes I have read and agree to your policies
Vitality Health Massage - Office Policy
Vitality Health Massage - Covid 19 Statement
Vitality Health Massage - Privacy Statement
Vitality Health Massage - FAQ
*OFFICE APPOINTMENTS ONLY* If you would like mobile massage, please complete our mobile massage form on our website: www.vitalityhealthmassage.com/mobilemassage
60 Minute Session
90 Minute Session
120 Minute Session
ADD ON SERVICES- Scented Creams With Arnica & CBD Massage Oil
CBD Massage Oil- $10
Free Hot Towels - $0
Polar Ice -$5
Green Tea Mint -$5
Geranium Sage -$5
Tangerine Basil- -$5
Vanilla Lemongrass -$5
*No Thank You*
1st Appointment Request- *This does not guarantee the date and time you choose but gives us an idea of what dates and times work for you so we can try to get you scheduled.
2nd Appointment Request- *This does not guarantee the date and time you choose but gives us an idea of what dates and times work for you so we can try to get you scheduled.
3rd Appointment Request *This does not guarantee the date and time you choose but gives us an idea of what dates and times work for you so we can try to get you scheduled.
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