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    Form : To make an appointment or request information

    If you want to make an appointment or you have any special requests, or need additional services, or would like more information for a Massage or Spa body treatment, please fill out the following:

    Please include full contact info (name, phone, email), location for sessions, number of people, age and gender, date and time, and any special requests. Feel free to ask me anything !

    Note: All information is confidential and discrete.

    Just complete this form. Click on Submit when ready to send.

    Your Name:

    Your Email Address:

    Your Address:

    Telephone:


    What is your Gender ?     Male      Female

    What is your Age?   

    Where would you like your Session?
    Your home
    My Studio
    Hotel

    How many People will Receive Treatments?
    1

    3 or more

    Appointment Information/ Any questions/ Special requests/ Comments?