Table Massage Request Form
We provide 5 Star Massages that straight to your location.
Let's get some info
Your Name *
If requesting a massage for someone else, what is their name?
Your Contact Number *
Your Email Address *
Massage Service Location (Complete Address) *
Where would you like to receive your massage? *
Where do we park? (Please note: you need to take care of parking, valet, toll roads) *
Preferred Date *
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Preferred Time *
Time
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Mobile Massage (From $125/ 60 min and $165/90 min)
Our licensed and insured Wellness Providers have high end standards to meet your professional massage needs. Please note: pricing may increase depending upon location, parking, or tolls. We are taking all the precautions to help prevent the spread of COVID-19. All wellness providers will be wearing masks and all equipment will be sanitized prior to your appointment.
What Service are you looking for?
Clear selection
Choosing your Wellness Provider
Clear selection
Would you like to add a Wellness Box with your Service?
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Clear selection
Do you have a Gift Card?
Please provide your Gift Card Number
Comments
How did you find out about us?
Appointment Confirmation
Thank you for your inquiry and we are looking forward to working with you. To confirm your appointment, we need completed health forms, a signed service agreement, and pre-payment via invoice.
I understand that once an appointment is confirmed, a health and environment form must be completed PER client. *
If you are having trouble with this form or have questions or concerns, please call us at: 888-540-1165
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