Contact Form

ALL requests for information and ANY communication between both parties is completely confidential. 

Note: This contact form is for women only.

This is the initial contact form. You will be given an opportunity to enter a more detailed consultation form before your session appointment.

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Full Name *

Email *

Best way to communicate? *

EmailTextWhatsAppSelect as many as you'd like.

PhoneVoice/Text/WhatsApp

Zip CodeClose to your location.0 / 5

Age *

Height

Weight

Body TypeSelect oneUnderweightSlightly underweightCorrect proportion to my height and weightSlightly overweightOverweightSelect one

Type of SessionSelect OneSensualSensual possibly EroticSensual probably EroticSensual and EroticNot sure at this time

Desired Results:Select OneTotal relaxationStimulatedSatisfiedLife changing experienceNot sure at this time

Which best describes youSelect OneI have never experienced orgasmI occasionally experience orgasmI easily experience orgasmPrefer to discuss in person

Best locationSelect OneI travel to Inspired Touch locationInspired Touch travels to my locationEither location is possible

About YouEnter a description of your body above. List any health-related issues. Max: 200 words.0 / 200

Best Days & TimesEnter the days of the week and approximate times that would be best for your session. Max: 200 words.0 / 200

Comment or QuestionsGeneral comments and questions can go here. Please let me know if you have urgent need, limited time frame or specific dates that you are in town. Max: 200 words.0 / 200

How did you hear about Inspired Touch?Select OneOnline searchSurfing the webReferred by friend

Our Agreement

By submitting this form I agree to the following: I am a consenting adult woman of legal age. I understand that Inspired Touch sessions are NOT fee based, no fees are required and no money will change hands. I also understand that Inspired Touch sessions are not traditional massage therapy and are not performed by a licensed therapist. I agree that all communication between BOTH parties will be kept private and confidential.

Submit Form

Please do not fill in this field.

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