sliding scale application — ianua healing arts

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sliding scale application

If you cannot pay the full exchange at this time, fill out this form to apply for a reduced rate.
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Name *

First Name

Last Name

Email *

Phone *

(###)

###

####

What is your preferred way for me to contact you? *

email

call

text

What services are you interested in? *

massage therapy

foot reflexology

saltwater foot soak

infrared light therapy

How long of a session would you like to experience? *

60 minutes

75 minutes

90 minutes

120 minutes

Other

Why are you requesting a reduced rate? *

How much can you pay for a session at this time? *

Please share your questions or anything else you'd like to communicate:

Thank you. I will be in touch shortly.

Location

W e s t v i l l e , N J 0 8 0 9 3

serving the greater Philadelphia area

Contact

ianuahealingarts @ gmail.com