Table Massage Request Form
We provide 5 Star Massages that straight to your location.
Let's get some info
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?
Outdoors (backyard, patio, balcony, must provide shade)
Inside the home (must provide ventilation, ie: fan)
Where do we park? (Please note: you need to take care of parking, valet, toll roads)
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?
60 Minute Massage (from $125)
90 Minute Massage (from $165)
60 Minute Couples Massage (back-to-back) from $250
60 Minute Couples Massage (at the same time) from $250
90 Minute Couples Massage (back-to-back) from $330
90 Minute Couples Massage (at the same time) from $330
Choosing your Wellness Provider
Female and Male (Couples Massage)
Two Females (Couples Massage)
Two Males (Couples Massage)
Would you like to add a Wellness Box with your Service?
Includes: 7oz candle, air plant, lavender pillow spray $45
No, thank you
Do you have a Gift Card?
Please provide your Gift Card Number
How did you find out about us?
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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