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Thank you for your interest in our Student Clinic. Please take a few minutes to answer some questions so that we can determine how we can best work with you.

Name:
 Date:
Street:
 Home Phone:
City, State & Zip:
 Work/Cell:
Email:
 Occupation:
How did you hear about Elements of Wellness?
Have you ever received a student clinic massage? Where?
If yes, would you please briefly share your experience?
How do you feel about being a part of a massage therapy student's education?

As a client in the student clinic you would be receiving whatever type of work the student needs to practice. This may be very different than the type of work that you may be acustomed to. How do you feel about that?
What about you will make you a good massage client for our student clinic?
Please check days and times on the chart below to indicate when you would generally be available for clinic appointments:
  9am - 12pm 1 - 4pm 5 - 9pm
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
     
Single Visit: $35 Please initial if you are interested in becoming a session paricipant:
Session Participant
(receive up to 6 weekly sessions):		 $100
   

 

 

 

Learn More
More information on the Massage Therapy Education program is available online.

Please contact us to learn more about the program or take a tour of our campus. Ready to apply? Our application is available online.