Relaxey.Workplace Chair Massage Inquiry And Booking Form

Please call 800-834-8350 or fill out the form below to book our services for Chair Massage for your organization.

Company:

Are you calling from a: Business Nonprofit Health Care
Educational Institution Religious Institution Political Organization

What your Company Does, In A Few Words:

Your Name:

Please Digitally Sign by Entering Your Initials Here:

Your Title:

E-Mail Address:

Work Number (Include Extension):

Direct Cell Phone Number:

Are you booking a session for TODAY? Yes No

If not, what's the date of the session you're interested in:

Time of session:

About How Many Hours Do You Wish to Book For:

What region?

Street Number and Name where the session will take place:

Town or City:

Neighborhood or corporate park name:

Type of building:

What floor is your company on?

What is the unit number or designation, if your company occupies a suite?

Is there free parking for our therapists? If there are special parking procedures, please state here:

Is there an elevator in your building? No Yes

About how many employees will be receiving Therapeutic Massage?

How many minutes do you want each person to receive?
( 10, 15, or 20 minutes are most common)

Is Chair Massage part of a larger effort? Please check all that apply:

Employee Appreciation Day

Reward For Hard Work

Company Brunch

Interdepartmental Meeting

Health Fair

Lecture

Symposium

Rally

If part of a reguarly-scheduled Wellness Program, how often do you think you'll be seeing us?
Once, monthly. Bi-weekly.. Weekly. Twice a week.

What are your goals and desired outcomes for Chair Massage?

Would you like to pay your deposit now by credit card? (reserve the date) Yes No

<-- (Please click 'Submit' at left to continue.

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