Bespoke Packages Form Bespoke Packages Bespoke Packages - Information Required: First Name * Last Name * Email * Phone Desired Dates: Venue Details: * Event Type: * Number of potential treatments: * Additional notes: I understand that the massage therapist will consider information about my physical condition, medical history, lifestyle, stress levels, medications and any areas of physical pain that could affect my massage therapy outcome. I also understand that all information provided will be used purely to help structure the treatment session to achieve my health and wellness goals. I declare that the information that I have given is correct and wish to proceed with treatments. I agree to disclose any medical condition, to determine my overall health and wellness goals Terms and Conditions: We want you to know how our service works and why and how we handle your data. Please state that you have read and agreed to these terms and conditions. reCAPTCHA I have Read and Agree to the Terms and Conditions * Yes Submit