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Sensual Tantric Naturist Derbyshire Massage

Male masseur for Ladies, Couples and Gents

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*** Sensual Tantric Massage ***

Weekdays from 10am to 4pm

Now Taking Bookings for March, April & May 2023

Pre- Massage Questionnaire

Please complete and submit this form before your massage takes place.

First Name

Email Address

Last Name

Date of Birth

1) Have you been hospitalised in the last 12 months? 2) Is your body temperature below 37.5 Celcius. 3) Are you currently experiencing a fever, sore throat or cough. 4) Have you been in close contact with anyone in the past 14 days who has been confirmed with Covid-19

Yes

1) Are you currently suffering from a medical condition, illness, or injury? 2) Ladies, are you currently pregnant? 3) Do you have any areas which you specifically wish to include / exclude from your massage?

Yes

If you answered yes to any question, please elaborate

Your Initials (as a digital signature)

Date completed

I declare that the info I’ve provided is accurate & complete.

Thanks for submitting! Namaste

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