Room Rental Request

Please complete and submit this form if you are a massage practitioner interested in renting a room at Body Therapy Services to provide massage services.

Contact Information
Salutation
First Name
Last Name
Street
City
State/Province
Zip Code
Telephone () -    ext.
E-Mail Address
Professional Web Address
Professional Information
1.  How long have you been providing massage services for income?

              years    months

2.  How many regular clients do you see weekly?

             

3.  Are you comfortable with the volume of clients you currently see on a weekly basis?

   Yes and I am not interested in increasing my client volume.

   Yes, but I would not mind a couple more clients each week.

   No. I would like to see an average of  clients each week.

4.  In what type of environment is your current practice located? Select all that apply.

Fitness center

Healthcare practitioner's office

Massage office

Medical / Rehab facility

Outcall - businesses, clients house

Practice not established at any location

Salon / Spa

Therapist home office

Wellness center

5.  List days and times you plan to regularly offer services.

6.  What amount of rent are you anticipating you may be paying for the times listed in question number 5?

7.  Which rental and payment option is most suitable for your business?

   Weekly with a fixed rate and pre-determined use schedule

   Monthly with a fixed rate and pre-determined use schedule

   Combination, fixed rate and as needed

   Only as needed 

8.  In addition to the days and times previously listed, list additional days and times that you may see clients and would require a service room.

9.  Please list your services and prices, if you have not previously specified a website that contains this information.
Professional Assessment
10.  Summarize your professional profile in 45 words or less.

Comments
11.  Comments, questions, or additional information you would like to share?
Please respond to all questions and queries for information prior to submitting this form. Incomplete forms will not be reviewed. Thank you.