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I Knead Serenity: Practitioner Listing
Looking for referrals? This form will help both of us to get started! (Looking to be removed? Please provide your e-mail and name and click the appropriate box at the end of this form. No other information required!)
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Email
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Your email
Your Name:
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Your answer
Your "Doing Business As" Name, if Applicable:
Your answer
Your Business Phone Number:
Your answer
How do you prefer to be contacted by clients?
Email, as listed above.
Phone, as listed above.
Other:
What is the nature of your business?
Sole-Proprietor - "I work for myself."
Independent Contractor - "I work for myself within the context of someone else's business."
Employee - "I work for someone else within their business."
Partnership, Co-Op, etc. - "My partner(s) and I share business interests."
Mobile / Out-Call - "I travel to the client's location."
Rent Space - "I have one or more physical locations that I work out of."
Home-Based Location - "I work in a space located on my property."
Other:
Where is your business located? If you offer mobile services, what is your service area?
Your answer
What kind of work do you do in your business? (i.e. deep tissue massage, Swedish massage, pregnancy massage, oncology massage, Reiki, Polarity Therapy, yoga, etc.)
Your answer
What is the price-range for your services? Do you offer a sliding-scale fee or any specific discounts?
Your answer
What are your hours of operation?
Your answer
Describe your target clientele:
i.e. Retirees, pregnant clients, athletes, post-surgical rehabilitation, office workers, laborers, other age ranges.
Your answer
If you use hands-on techniques, how would you describe the depth of your touch?
While you may be capable of adjusting your pressure to your client's preference, please pick the range that's most comfortable for you. If not applicable, leave blank.
Light (Gentle Brushing)
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Deep (Rolfing)
Clear selection
What is the *one* technique or modality you love to do the most?
Your answer
Are there some techniques or modalities that you don't enjoy doing? Are there any that you absolutely don't want to do at all?
Your answer
Use this space for any and all social media links you'd like to share (i.e. website, scheduling site, Facebook, Instagram, etc).
Your answer
Do you have any questions or feedback for me? Do you have anything else that you would like to share?
Your answer
"By selecting the checkbox below and submitting this form, I am consenting to the use of the information provided above for the purposes of referring my services to and connecting with potential clients. I have reviewed and agree to I Knead Serenity's Privacy Policy and Terms & Conditions."
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