Vitality Funds Application
This fund is being made available to BIPOC & LGBTQIA+ communities that may be underserved and without access to massage therapy. If you don't identify in a minority group, you may still apply knowing that priority will be given to BIPOC & LGBTQIA+ communities.
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Name *
Preferred Pronoun *
Email address *
Phone number *
Which community do you identify with? *
Goals for massage therapy session: *
Request: *
If selected for an appointment, I understand that it is my responsibility to: *
Yes
No
Need more information
Comply with state mandated COVID protocols as explained by Linda Caravia of Vitality Therapeutic Massage & Yoga, LLC (once selected, you will be sent a liability release with full a explanation)
Fill out a COVID19 Liability release
Fill out a health intake form
Be 100% honest about my health status
Attend the scheduled appointment at the agreed upon time
Be on time for my appointment
Reschedule or cancel the appointment if I am not feeling well. I understand this may mean the funds go to the next person waiting.
Linda specializes in barefoot massage, it's important to find a therapeutic match for a session. Barefoot massage is not suitable for everyone. Due to the compressive nature of this modality, therapists must take extra precautions with certain client conditions, including but not limited to (please indicate any of your conditions some questions will be asked again in the health intake form): *
Thank you! Massage therapy sessions will be given in order of requests, with priority given to the BIPOC and LGBTQIA+ communities. Please be patient, you will be contacted as soon as a therapeutic massage becomes available to you. You are welcome to leave any additional information here:
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