HT Appointment Request Form

Appointment Request Form

Thank you for choosing C. Natasha Massage for your therapeutic needs. Please take the time to answer a few questions so we can best meet your needs!
Full Name*

First NameLast Name
If you are completing this form for someone else, please be sure to include their name.

First NameLast Name
Contact Number*
Please enter a valid phone number.
Email Address
example@example.com
What date and time works best for you?*
Any other specific date and time, if the above selection is not suitable*
Which kind of massages suits your needs?*
What modalities are you interested in? How long will each session be? Please specify how many of each.*
How many adults will be receiving massages?*
How many children?
Children 18 and under must be accompanied by a parent or an adult for the entire duration of the session.
Are there any persons in your party who are pregnant, disabled or need special accommodations?*
Where will your session(s) be held?*
Additional costs apply. House calls are available as schedule permits.
If at a home/rental/on a boat, please provide the name and location.
We kindly ask that you send directions and a location pin or photo through WhatsApp, iMessage or email to ensure prompt arrival.
If at home/resort/on boat, is there sufficient space for two twin beds? *
Must be in a cool, completely shaded/enclosed area with access to electrical outlets.
Would you like dual therapists for side by side massages or one after the other?*
What’s your preferred method of communication?*

Phone callWhatsAppiMessageEmail
Please indicate any health conditions, allergies, medical conditions or contraindications that your therapist should be aware of.
Please feel free to add any additional information pertinent to your request.
TERMS & CONDITIONS

Please note that once you have booked an appointment with us, it means that we have reserved time in our schedule exclusively for you.

If you cancel your appointment less than 48 hours before it is scheduled to take place, you will be subject to a charge of half of the total service rate.

To avoid a cancellation fee, please provide cancellation notice at least 48 hours prior to your appointment.

You can cancel or reschedule an appointment by calling/texting 242-427-9461 or emailing us at cara@cnatasha.com
Before submitting this request, please review and ensure all pertinent information is accurate.
Should be Empty: