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To request an appointment, please fill out the form below and click "Submit." Fields with an asterisk "*" are required fields.

Current Clients:  Confirmation of your appointment time may be by telephone (rather than email), so please indicate in the message box the best times I can reach you by telephone if needed.

New Clients:  In order to better assess your needs, it is my policy to talk with each new client briefly before confirming a first appointment. Please indicate in the message box the best times to reach you by telephone.

Please allow 24 hours for a response by email or telephone. A requested day and time period is not guaranteed, but I will do my best to find a time that works for you.

Subject: 

*Name: 

*Email Address:  

*Telephone number(s):  

                    (Tuesdays through Saturdays only)
*Request date:  

                                (Start times from 12:00 noon to 6:00 p.m. only)
*Request time:
 


*Length of massage:  

*Client type:  

For new clients:   

How did you hear about me?  

Referrer's name:  

Special message or questions: