Add your info
Are you willing to provide a state issued ID? This will be used for verification purposes and for the safety of the Massage Therapist.*
Yes
No
Do you understand that Massage Therapy is a recognized form of healthcare and not illegal sexual services(prostitution or Sex Trafficking)?*
Yes. There will be no harassment of any kind nor any sexual advances made
I understand that myself, therapist or any staff may refuse or stop service at any time.
I understand that a police report will be made when necessary
I will forfeit my opportunity for therapy and a refund if I am inappropriate with any staff
No tolerance. Any of the above occurrences will result in immediate dismissal from this practice
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Join Cancellation List (Established Clients only)
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First and last name*
Mobile number
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