Online Booking Request For Return Clients

Online Booking Request

* Indicates required field

Name *

First

Last

Email *

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

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

Will you require a Health Fund Receipt? *

Yes No

What treatment would you like? (Prices are for 1 person) *

30 Min Massage $50 (if booking for 2) 45 Min Massage $65 (if booking for 2) 1 Hr Massage $80 1.5 Hr Massage $115 2 Hr Massage $150

What treatment for second person? *

30 Min Massage 45 Min Massage 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. *

Additional comments or queries *

Submit

Create your own unique website with customizable templates.