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Massage Therapy Inquiry
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Have you had a professional massage before?
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Have you had a professional massage before?
A
Yes
B
No
Why type of massage therapy experience do you seek?
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Why type of massage therapy experience do you seek?
A
Relief from chronic pain
B
Cupping Therapy
C
Deep tissue/sports massage
D
Swedish Massage
E
Thai massage/stretching
F
Custom treatment plan
G
Guidance with yoga and asana
H
Not sure
By signing here, you consent to be contacted by G. Jean to inquire about providing massage therapy services; you also acknowledge and understand that G. Jean is a licensed massage therapist and that your relationship with them will be therapeutic in nature, and all communications will be professional, friendly, and clear.
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Signature
Upon submission of this form, G. Jean will contact you regarding the date and time that you would like to have your massage therapy experience and inquire further regarding the answers provided within this form.
Submit
