*1.Name(Required.)

*2.Phone #(Required.)

*3.Email(Required.)

*4.Any current or past injuries that required surgery or rehab? If so, explain. If no, type "n/a"(Required.)

*5.What are your goals and/or problem areas? (i.e tight hips, low back pain)(Required.)

*6.House call or coming to studio?(Required.)

House Call (Metro-detroit)

Studio

*7.What day(s) are you available?(Required.)

Monday Morning (8-12pm)

Tuesday Morning

Thursday Morning

Friday Afternoon (3-8pm)

Saturday Afternoon

Sunday (all day)

*8.I request payment prior to session with a 12hr cancellation and refund policy. Do you agree to this? Cash is not accepted except for tips :)(Required.)

Yes

No

*9.How will you be making your payment?(Required.)

Zelle

CashApp

Apple Pay

Bartering