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Company Name:

Your Name:

Street Address:

City: State:

 Zip Code:

Phone (with area code):

Fax (with area code):

Email Address:

How did you here about us?

Approximate Number of Recipients:

Number of Minutes Preferred
for Each Session (if known):

Date(s) & Time(s)
For Seated Massage (if known):

Are you interested in:
A one time event
An ongoing program
A seasonal program

Main Purpose for Seated Massage:
Reduce Stress & Absenteeism
Boost Morale & Productivity
Employee Reward & Recognition
Wellness in the Workplace
Office Party/Special Event
Open House/Marketing Event