Online Booking Request for New Clients

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Online Booking Request
For New Clients

* Due to limited availability, I am unable to book any new clients at this stage. (Some exceptions for referrals)
Please visit website again for future updates.

Prices & Treatments

For Direct Deposit Payments, your therapist will supply you an invoice with banking details on the day. Sorry, no credit card facilities.

Online Booking Request

* Indicates required field

Name *

First

Last

Email *

Phone Number *

Address of Home, Accommodation or Workplace *

This is the address where we will visit

Any additional info? eg. parking, gate entry, dogs, etc. *

What dates & time frames suit you? *

Please provide at least 2 dates & time frames that would be suitable. List the first one as your preferred choice.

How would you like to pay? *

Cash on the Day Direct Deposit on the Day

For direct deposit option, I will supply an invoice with details for funds transfer.

Do you, or second person require a Health Fund Receipt? *

Yes No

Name your Health Fund/s *

What treatment would you like? *

1 Hr Massage 1.5 Hr Massage 2 Hr Massage

What treatment for second person? *

1 Hr Massage 1.5 Hr Massage 2 Hr Massage

A booking for 2 people is performed one after the other.

Name of second person *

If you require massage for more than 2 people, please list details below *

If you have had any serious injuries, medical conditions or operations in the last 6 months please list. *

How did you find or hear about us? *

Google Search, Recommendation, Social Media, Etc.

I have read & agree to the Terms & Conditions *

Yes

Submit

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Home
About
Prices
Gift Voucher
Testimonials
Blog
Contact

Online Booking Request​For New Clients

Online Booking Request

Online Booking Request
For New Clients