New Schedule Form

Schedule Your Therapy

Full-Body Pampering by Richard, Deanna or Both?!

Personal Info:
Name: *
E-mail: *
Cell Phone:
Contact Phone:
Your Website:
Your Massage:
Massage Date:
Time of Massage: *
Therapist(s): *
Massage is for:
Massage Address: *
Cross Streets:
Directions if known: *
Client's Info:
First-Last: *
Birthdate:
Occupation:
I am a:
2nd Client's Info:
First-Last:
Birthdate:
Occupation:
I am a:
Optional Services:
Therapy Requested:	Regalsage 40 Minutes (incall) $70.00 Regalsage 60 Minutes $110 Regalsage 90 Minutes $160 Regalsage 120 Minutes $220 Full-Body Salt Glow $60.00 Prostate Therapy $60.00 Full Body Wash $60.00 Romantic Evening 2+ Hrs $600.00 Tantrasage 2 Hours $300.00 Tantrasage 3 Hours $400.00
Totals:
Total Fees:
Deposit (Min $55)
Date of Deposit
Unofficial Cash Balance:
Additional Info:
How did you find us?: *
Please Read:
PLEASE READ: Thank you for your submission! To place your massage date on our schedule requires a $55 deposit ($50 credited to balance due to bank fee). Send your deposit now by clicking "Schedule" (above) then click on "MAKE DEPOSIT" Once your deposit is received, you'll be mailed a complete invoice within 24 hours detailing all fees based upon your selected options with your CASH BALANCE DUE prior to your massage therapy. Your servant, Richard
ARE YOU HUMAN? IF SO, WRITE THE WORD IN THE BOX? ROBOTS CAN'T DO THAT! *

Full-Body Pampering by Richard, Deanna or Both?!