"Family Express Foot Massage" On-Site Foot Massage / AGONY OF DAFEET, INC.

This form is for visit booking purposes only, not for payment.
(Payment options are listed here.)

Home visits for the entire family!
(We also take on small business and corporate gigs, as well.)

$20/20 mins., $30/30 mins.

AGONY OF DAFEET relaxation foot massage is non-erotic and strictly professional. Thank you, in advance, for your cooperation!

First Name:

Last Name:

Type of Visit:

Email Address:

Company (if applicable):

Session Length Desired:

Foot Massager Requested:

Number of Foot Massages:
(Approx.)

Optional $5/5-Min Foot Bath?
(You provide warm water, we provide the Epsom and apple cider vinegar. The bath promotes blood flow and prepares the feet for massage, yet is not required in order to enjoy your foot massage visit.)

No		Yes

If yes, how many soaks?

Desired Visit Date:
(e.g. mm/dd/yy)

Phone:

City:

State:

Zip Code:

Comments/Questions/Please list first names of home foot treatment recipients:

(For Corporate/Tradeshow visits, please also specify preference for male, female or combination of the two. We can help you to decide, based upon your workforce gender ratio:)