Full Name *

Phone *

Email *

Date of birth *

Address *

City *

State *

Postal code *

Occupation *

Desired goal/goals for this therapy? (Example: Relaxation, Pain Management) *

Are you allergic to coconut oil? *

Yes

Explain where you have complaints: *

Surgery or Injury? *

What is your pressure/intensity preference? *

Light

Medium

Firm

How did you hear about us?

Social media

Google

Referral

Cancelation Policy

We at NOLA Stretch & Recovery, LLC understand that situations may arise, leading to a cancelled appointment. We kindly request a minimum of 24 hours’ notice for cancellations or rescheduling. Failure to provide an adequate notice may result in a cancellation fee. Cancellation fees can be paid through a card on file or over the phone before booking a new appointment. The cost of the appointment will be charged. This fee covers the time reserved for the practitioner as well as the impact on scheduling. Clients who wish to reschedule their appointment must do so within 24 hours of their original appointment time to avoid cancellation fees.

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