Mini Sessions Booking Form | A Little Calmer

Your First Name*

Your Surname*

Your Email Address*

Your Mobile Number

Select Treatment Choice*

Indian Head Massage (20 mins)

Reiki (20 mins)

Combination treatment (40 mins)

What are you seeking healing for right now?

Additional Comments

I have read and understood the contra-indications above and their relevance to my treatment and given an accurate account of any current medical conditions.*

Agree

Disagree

Not Applicable

I consent to proceed with treatment and agree that this is at my own risk.*

Agree

Disagree

Mini Sessions

Booking Form

Please ensure you read and agree to the information below.

INDIAN HEAD MASSAGE TREATMENTS: Please read through the list of medical conditions carefully and select any that apply to you. Some of these conditions may be agitated by an Indian Head Massage treatment and, in some cases, a referral from your doctor may be required. If you select any of the conditions listed, please be advised that it is recommended you seek medical advise prior to having this treatment and, if you proceed without medical advice, it is at your own risk.

Mini Sessions

Booking Form

Please ensure you read and agree to the information below.

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