First Time Massage Client Form

Thank you very much for taking time to fill out this form. It is greatly appreciated! I hope to reply to you within 1 business day.

Upland, Indiana 46989


            License Information:


 License No:

Profession: Massage Therapy Board
License Type: Massage Therapist
Obtained By Method: Grandfathered
Issue Date: 7/22/2010
Expiration Date: 5/15/2013
License Status: Active


Thanks for visiting my website and I look forward to hearing from you soon!  -Jennifer M. Webb, L.M.T.