Massage, WATSU, CranioSacral, Lymph Drainage Therapy- Welcome to Dunsmuir's Resort Quality Treatment Facility

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SEIDLITZ FAMILY

Water And Land Massage

Assisting Health

                                       MASSAGE,
                                                                WATSU(R), SHIATSU,
                                                                   CRANIOSACRAL,

LYMPH DRAINAGE THERAPY
Living Foods Instruction

Treatment Request:

IMPORTANT: Please tell us WHO the treatment will be for, WHEN, and WHAT treatment you would like. Be sure to provide us with CONTACT INFORMATION, so that we will be able to reach you to confirm that an appointment is available.

Select Treatment Requested:

Indicate Your Preferred Treatment Date, Time and Contact Information.

(Please fill in each field and then TAB to the next before sending your request. Thank you!)

Treatment Day / Date Requested

Treatment Time of the Day Requested (i.e. Evening)

	**Client Name (to receive treatment) Name of person scheduling appointment Contact Person (to be contacted to confirm appointment)**
	Contact Person's City, State, Country
	Contact Person's Telephone
	Contact Person's E-mail Special Comments or Requirements: Please check to be sure ALL FIELDS, ESPECIALLY CONTACT INFORMATION, ARE CORRECT BEFORE submitting request. Thank you. We look forward to seeing you at WALMAH!

You should receive an email or telephone reply within 24 hours. Thank you for your interest!

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Select Treatment Requested:

Indicate Your Preferred Treatment Date, Time and Contact Information.

(Please fill in each field and then TAB to the next before sending your request. Thank you!)

Special Comments or Requirements: