Are you filling out this form for yourself or someone else? * I identify my gender as: * Other (Identify as / Personal pronouns) Phone Number * Email Address * I would like to request an appointment on: *
What days work best for you? Mornings or afternoons?
Masks are required. Do you agree to properly wear a face covering over your nose & mouth for the full duration of your appointment? *
REVITALIZE YOUR ROOTS MASK POLICY: Due to the nature of massage and working very closely together for long intervals, face coverings are required by all clients and the massage therapist for the full duration of the appointment, regardless of vaccination status. There is a built-in covering in the face cradle, and clients can take masks off when face down only. Appropriate face coverings do not include masks with holes or one-way valves.
Have you had a professional massage before? * Occupation What type of appointment would you like to schedule? * Table Massage Table Massage Thai Massage (**SEE NOTE BELOW)
**Currently on hiatus from Thai Massage. Check out Thai Yoga Strength on Charlotte Pike!
What appointment duration would you like to schedule? * 90 minutes (Most Popular) 90 minutes (Most Popular) 60 minutes
See the offerings page for rates and service descriptions. Your appointment time includes an intake interview before we get started.
Want more hands-on time? I don't blame you! If you're able to, I always recommend booking at least 90 minutes. 120-minute sessions not available for first-time clients.
Pressure Preference * (1-3) Light pressure - Swedish (relaxation) massage, release tension, increase circulation (4-5) Medium pressure - firm Swedish, release tension, increase circulation (6-7) Firm pressure - targets deeper muscle layers, incorporates some therapeutic techniques (8-9) Very firm pressure - therapeutic, targets deeper muscle layers, incorporates mostly therapeutic techniques (10) Deep pressure - therapeutic, very deep, slow, sustained pressure, trigger-point therapy, can be painful
Scale of 1 to 10. 1 being lightest pressure, 10 being very deep pressure.
How did you hear about Revitalize Your Roots? * Please select your reason(s) for choosing massage therapy * Which of the following best describes your main goal for massage therapy? * Mainly relaxation, with general tension relief Strictly relaxation Mainly targeted, therapeutic bodywork Please describe any injuries (current or past) or illnesses, and when they occured Do you participate in any regular physical activities? Revitalize Your Roots offers a non-judgmental, body-positive, healing space. If you have any hesitations or fears regarding massage therapy, please know that this is a safe space to voice them. Let's work together to ease your worries so you can have a relaxing, healing experience. You deserve it! Do you have any questions for your massage therapist?