• Independent Contractor Application

    Shared Client Room

  • Thank you for your interest in offering services at The Gestalt House. This application helps us understand your practice, your schedule, and whether our shared treatment room is a good fit.

     

  • Format: (000) 000-0000.
  • Do you currently or have you operated under a business name?
  • Business Type*
  • Which license(s) or certifications do you hold? (Select all that apply)*
  • Are you currently insured?*
  • Are you currently seeing clients?*

  • Room Supplies that are included:

    • Build in Storage
    • Massage Table
    • Bench
    • Rolling Stool
    • Rug
    • Bed Spread
    • Pillows
    • Facial and Body Towels
    • Towel Warmer
    • Bed Warmer
    • Blue Tooth Speaker
    • Moon Light
    • Hot Stone Kit
    • Basic Consumables (Optional - depending on needs)
    • Massage Lotion/Butter (Optional - depending on needs)
    • Basic Facial Products (Optional - depending on needs)
    • Use of Facial Steamer
    • Wall Clock
    • Plants and Decorations
    • Other needs can be discussed
  • Are your hours flexible?*
  • How soon are you hoping to begin?*
  • Are you able to maintain your own scheduling, pricing, and client communication?*
  • Are you comfortable working as an independent contractor under a shared room model?*
  • Are you able to maintain a clean, neutral, and reset treatment room at the end of each workday?*

  • Professional References

    Please provide 2 professional references.
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.

  •  

    Acknowledgment

    By submitting this application, you acknowledge that this opportunity is a shared treatment room, offered under an independent contractor agreement, with non-exclusive access, and requires adherence to all building policies, boundaries, and sanitation standards.

  • Signed Date*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Should be Empty: