Massage Therapist Form

Forms

Massage Therapist Form

Fill out this form to join our search engine for consumers looking for Massage Therapy.

Upon completion of this form, please email a copy of your license to ivaluemassage@outlook.com Photos are optional. If you would like to have a photo posted with your listing, please include one in your email.

iValuemassage.com promotes its site via a co-op marketing method through donations only. We ask all participants who post on our search engines to kindly donate. Donations are optional and greatly appreciated and are used to advertise to increase site traffic! You can make your donation at http://www.ivaluemassage.com/#!donate/c1znx

First name:
Last name:
Please add your professional suffix, e.g., LMT, CMT
Email address:
Company:
Company Address:
City:
State:
Zip code:
Phone:
Modalities Practiced
License Number:
Website:
Do you accept insurance?
What do you value most about Massage Therapy?
I agree to keep all state required documentation current. Type yes and initial.
Referred by: