New client consult form massage | Ambient Home Group

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New Client Massage Form
(Please fill out this form prior to booking)

First Name

Last Name

Email

Street Address Line 2

Street Address

City

Region/State/Province

Postal / Zip code

Country

Code

Phone

Which massage are you after? eg 1hr/1.5hrs

I have an injury or illness that I need to discuss prior to my massage

I have an allergy (please specify above)

I like gentle pressure

I like medium pressure

I like firm pressure

I agree to the terms & conditions

Add extras

Scalp, facial and neck massage +$30

Hand and arm massage treatment +$20

Foot scrub and polish +$20

Exfoliating backscrub treatment +$15

Frequency of booking

Tell us more

Thanks for submitting! Our team will be in touch shortly.

Mon - Fri: 8am - 5pm
Saturday: 9am - 7pm
Sunday: 9am - 8pm

Including Holidays

Hawthorn, Victoria, Australia.

+61745206393

Website designed by Lauren Main

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