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The Ultimate Massage For Men
Preliminary Questionnaire

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Blue Bouncing Arrows 4

the latest advances in modern massage therapy
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In an effort to provide you with the most enjoyable and beneficial experience possible, I ask that you complete the following questions to the best of your ability and submit this information to me as soon as possible.

Your answers will be kept in the strictest of confidence.

Or I can e-mail a copy of this "Preliminary Questionnaire" to you.

Thank you for helping me make your session a much more rewarding experience.

to submit your responses to my "Preliminary Questionnaire, click here

*** if you have not received a response from me within 24 hours after submitting your questionnaire responses - or you received any kind of error message after pressing the submit button above - please contact me directly via email or telephone

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By submitting this information, you are certifying that you are of legal age (considered an adult) in the municipality in which you reside.

By submitting this information and requesting a private session with me, you are certifying that you are not a member of any law enforcement or public regulatory agency.

By submitting this information and requesting a private session with me, you agree that you are willingly and authentically expressing an interest in participating in this experience and are not being paid by any third party to attend this session and are acting of your own free will as a consenting adult solely for the therapeutic benefits which may be derived from the session.

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