Welcome to Gypsy Mobile Massage

Please fill in your details below,

before your treatment.

First Name *

Last Name *

Email *

Phone *

Please check the boxes: *

INDEMNITY I understand that this information that I have given is strictly confidential between the therapist and me. I accept that the practitioner cannot be held liable for any for injury, illness or death based on the nature of the treatment. I have chosen to receive this treatment out of my own free will. I acknowledge that this is a non-sexual service. I acknowledge that the treatment is not a substitute for medical intervention.

POPIA It is noted that all client information is confidential and required for our record keeping purposes only. I confirm that I want to receive occasional messages from Gypsy Massage.

I CONFIRM THAT I AM IN GOOD HEALTH TO RECEIVE A MASSAGE

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