Shared Wellness Treatment Room Application

Shared Wellness Treatment Room Application
Thank you for your interest in joining The Gestalt House as an independent practitioner. Please complete the application below so we can learn more about your practice and determine whether our shared treatment room is a good fit.
Full Name*

First NameLast Name
Business Name*
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Email*
example@example.com
Website Address*
Social Media Accounts*
What services do you offer?*
Are you able to maintain your own scheduling, pricing, and client communication?*

YesNo
Are you comfortable working as an independent contractor under a month‑to‑month lease?*

YesNo
Are you able to maintain a clean, respectful, and collaborative shared space?*

YesNo
Have you rented a treatment room or professional space before?*

YesNo
Have you rented a treatment room or professional space before? (If yes, please provide previous rental history. Provide Where - How long you were there. - And why you left)*
Please provide 2-3 professional references. (Name, Relationship to you, Phone and Email address)*
Desired start date?*

MonthDayYear
Date
How many days a week do you want?
Which days work best for you?*

MondayTuesdayWednesdayThursdayFridaySaturday
What’s Included:
- Fully furnished treatment room
- Massage table
- Towel warmer
- Linens provided, with laundry service included
- Some standard massage and spa supplies, and other equipment/tools
What You Bring:
- Your own specialty products, tools, and modality‑specific supplies
- Your own clients, scheduling system, and business operations
- A commitment to maintaining a respectful, clean, and collaborative shared space
Room Personalization
- You are welcome to bring shelf/counter decorations for personalization
- You are welcome to use your own blanket/spread during your rental days
- No wall art/decorations are allowed in this room
- You are welcome to offer retail product in the room in the product area
- None provided linens are not part of the laundry service
Rental Structure
- 2 days per week - Flat rate of $200 on a Month‑to‑month lease
- 3 days per week - Flat rate of $300 on a Month‑to‑month lease
- 4 days per week - Flat rate of $400 on a Month‑to‑month lease
- $200 deposit and first months rent due at signing
- No commission requirements
- No employment relationship
- Predictable access to the room on your scheduled days
What other items/tools/equipment/products would you like made available to you in the room?*
Acknowledgment
By submitting this application, you acknowledge that this opportunity is a shared treatment room rental, offered on a month‑to‑month lease, at $300/month with a $200 deposit, and is not an employment position.

After submitting your application, you will be redirected to an appointment calendar to schedule a room showing.
Full Name*

First NameLast Name
Today's Date*

MonthDayYear
Date
Should be Empty: