Let’s work together

Please complete this short form so I can learn more about you, your goals and how we can best work together. All submissions are reviewed for fit before booking is offered. Once reviewed, you will receive a follow-up with further booking instructions. Thank you for supporting my small business!

Name

First Name

Last Name

Phone

(###)

###

####

Preferred Contact Method

How did you hear about us?

If you were referred by a friend or clinician, please include their name below. Our SGV space is available by approval and referral only

What services are you interested in?

Routine Wellness Lymphatic Drainage

Orthopedic Post-Operative Manual Lymphatic Drainage (MLD - Vodder)

Lymphedema Manual Lymphatic Drainage (MLD - Vodder)

Cosmetic Surgery Manual Lymphatic Drainage (MLD - Vodder)

Which location are you interested in?

Burbank studio is open to all bookings. SGV studio is referral + approval based only. Mobile services are offered by availability. Travel fee applies in addition to service price. Mobile coverage zones - Pasadena, Glendale, Alhambra, Eagle Rock, La Canada, La Crescenta/Montrose, Highland Park, Mount Washington, Burbank, Los Feliz, Toluca Lake

Have you ever received Manual Lymphatic Drainage or Brazilian style drainage before?

Yes

What are your main goals for your session?

Reduce bloating, nervous system reset, sclupt/tone, post surgery recovery, hormonal/cycle support, etc...

Anything else you would like me to know?

Feel free to share any details that would help me tailor your experience ( e.g. surgery type, scheduling, sensitivities, accessibility)

Let’s work together

haus of lymph