YOUR Name (The "authorized micros/folio signer") *

First Name

Last Name

YOUR direct/best phone number *

You will be CALLED BACK on this number

(###)

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GUEST Name *

If more than one guest (couples or two parties) please provide "primary" guest name.

First Name

Last Name

GUEST direct/cell phone number

Our booking system sends a booking confirmation and reminders via SMS/text (field not required)

(###)

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What is anticipated date for service?

MM

DD

YYYY

Requested Service *

Select any, as not all services may be available at the time requested

Massage (60min)

Massage (90min)

Facial (60min)

Special Occasion Service

Couples Service

Multiple or Combo Services

Other Specific Service(s) Not Listed

Would you like the Hideaway to offer any of the following?

NOTE: Advanced booking notice required, cannot confirm all requests can be met!

Small Hideaway "Gift Bag"

Small Bottle of Prosecco

Chocolate Covered Strawberries

Something else specific (please verbalize during call)

None