Waitlist Request
804-837-4292 | vhm.massage@gmail.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. If you are a new client of Vitality Health Massage, you will be required to complete our intake form. If you are a resident of Brandermill Woods, you may pay using your keyfob when you arrive at your session so please call 804-837-4292 and I will help you schedule your appointment. We will notify you if there is a cancellation or if there becomes an open appointment for the day your looking for.
Please Pick Which Option Applies To You
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Brandermill Woods Resident/Employee- Booking At Brandermill Woods
Brandermill Woods Resident/Employee- Booking At My Office-Vitality Health Massage
New Client- Booking At Vitality Health Massage
Returning Client At Vitality Health Massage
Mobile Massage- Where I Would Come To You- Please visit: www.vitalityhealthmassage.com/mobilemassage
Todays Date:
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Month
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Day
Year
Date
Client Full Name:
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First Name
Last Name
Email Address:
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example@example.com
Phone Number
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Area Code
Phone Number
Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
What Type Of Massage Were You Looking For?
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30 Minute Session
60 Minute Session
90 Minute Session
120 Minute Session
Brandermill Woods Resident Only- 45 Minute Sesion
Brandermill Woods Resident Only- -60 Minute Session
Brandermill Woods Resident Only- -90 Minute Session
What Add On Services Would You Like To Add? (Not Available At Brandermill Woods, But You May Have These Additional Services If You Would Like To Schedule At My Office Location)
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Cupping
Hot Synergy Stones
Face And Scalp Massage
CBD Massage Oil (Musle Recovery)
Vanilla Lemongrass Arnica Cream
Lavender Arnica Cream
Green Tea Mint Arnica Cream
Polar Ice Cream
Warm Towels
No Thank You
Please leave any comments or questions here for the therapist. Let me know what day and time you are looking for.
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Thank You!
If you wish for me to stop sending you notifications, you can email me at vhm.massage@gmail.com
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