Therapeutic Massage Appointment Form

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WE ONLY PROMOTE THE ELITE AND CLASSY MASSAGE THERAPISTS; BEAUTIFUL YOUNG FEMALES WHO ARE DISCRETE, RELIABLE AND GENUINELY LOVE MEETING NEW GENTLEMEN. SIMPLY PUT; OUR REPUTATION AS A PREMIUM MASSAGE AGENCY SPEAKS FOR ITSELF. WHETHER YOU WANT TO MEET A STUNNING BLONDE OR A BUSTY BRUNETTE FOR ANY TYPE OF BOOKING; WE ARE GUARANTEED TO HAVE THE PERFECT LADY TO FULFIL YOUR WILDEST FANTASIES. PRIVATE, SOCIAL AND CORPORATE BOOKINGS ARE ALL WELCOME AND SHOULD YOU HAVE ANY SPECIAL REQUESTS, SIMPLY ASK ONE OF OUR OPERATORS WHO WILL BE DELIGHTED TO ASSIST YOU.
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Full Name* This field is required.
First Name
Last Name
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Email Address* This field is required.
example@example.com
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Phone Number* This field is required.
Please enter a valid phone number.
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Address ( Skip if you’re going for InCall )
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
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Other
Country
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Preferred Appointment Date and Time* This field is required.
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Are you 18 years of age or older?* This field is required.
Yes
No
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For additional confirmation, we need you to provide your D.O.B* This field is required.
Date
Month
Day
Year
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Type of Massage* This field is required.
Swedish Massage
Deep Tissue Massage
Sports Massage
Hot Stone Massage
Aromatherapy Massage
Nuru Massage
Shiatsu Massage
Thai Massage
Chair Massage
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For all new clients, a refundable booking deposit and accommodation fee will be required prior to scheduling the first session. This policy applies to all new clients, except for those with an established history of regular bookings with us. This measure is necessary due to the recent increase in incidents of social and physical abuse towards service providers, and we appreciate your understanding and cooperation. Do you understand?* This field is required.
Yes
No
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Do you have any medical conditions or injuries we should be aware of?* This field is required.
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Would you like a happy ending?* This field is required.
Yes
No
Maybe
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Are you clean and can you provide your last test result?* This field is required.
Yes
No
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How did you hear of Serenity Touch Massage?* This field is required.
Social Media
News
School
Through a friend
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How do you intend to make payment?* This field is required.
Apple Pay
Cash App
Chime
PayPal
Venmo
Zelle
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Additional Notes or Requests
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LET’S CREATE A MEMORABLE, SOOTHING EXPERIENCE THAT’S ALL ABOUT YOUR COMFORT AND PLEASURE. LOOKING FORWARD TO CONNECTING WITH RESPECTFUL, OPEN-MINDED INDIVIDUALS ONLY. 😘
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Please verify that you are human* This field is required.
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