Massage Therapy Intake & Booking Form
Name
First Name
Last Name
Phone Number
Please enter a valid phone number.
Preferred Contact Method?
Text
Call
Email
Which Massage Services are you requesting?
Full Body Therapeutic
Light Body
Massage Gun Therapy
Not sure / lets decide together or Combo
Location?
In-Home Massage (Clients Home)
At Mikes Private Space
Unsure, Need to Discuss
Massage Agreement & Consent : “I understand that this massage is for therapeutic and relaxation purposes only. I agree to communicate any discomfort, and I confirm I am 18+ years of age.”
Continue
Continue
Should be Empty: