Offline Printable Reservation/Appointment Form

Please fill out the below Printable Form and mail to Acadia Massage - PO Box 948 - Bar Harbor, ME 04609 in order to make an appointment. If making a reservation for more than one person, please submit separate forms.

  	Name:   
  	Address:
  	City:    State:  Zip: 
  	Country (if other than USA):  
  	Phone:   FAX: 
  	E-mail: 
Vacation Dates:
Local/Hotel Address:
Local/Hotel Phone #:
Fitting Massage(s) Into My Vacation: (Optional/Multiple Choices)
Check-in Massage Wake-up Massage Mid-Day Siesta Early Riser Sleepy Head
Long, Hard Day Stressed to the Max Rehabilitation Corporate Massage Therapist Choice
Therapy Time, Date and Location Choices: (Please Enter Three Time Choices between 7am and 8pm)
1st Choice:
2nd Choice:
3rd Choice:

Make Multiple Date Choices: (mm/dd/yy)
1st Choice:
2nd Choice:
3rd Choice:
Location: My Hotel      Your Office      My Home
Therapy Length: 1 Hour      1 1/2 Hours      2 Hours     
Deposit Submitted: 1 Hour - $25      1 1/2 Hours - $37.50      2 Hours - $50

Deposit Policy: A $25 per hour Deposit is required to reserve this time for you. Deposits may be refunded only if cancellation is received 30 days before appointment. Deposits from cancellations after that date may be applied to future appointments on a space available basis. Times and Days within your vacation may be changed on a space available basis. Your deposit will be applied to the total cost of your Appointment. If you accept this Deposit Policy, please complete this Secure Form and Send to us. You will receive a confirmation and receipt of your payment.
Payment Information: (Select your payment type)
VISA     MasterCard     Check or Money Order    Payment Amount $
Name on card
Credit Card Number Expires
Comments or Specific Therapy Requested: