Gift Certificate Order Form
Innerpeace Natural Healthcare
32A Uno Circle Joliet, IL 60435 (815)773-2373
Order forms faxed to (815)773-2374
Massage Services
Price Qty Amt Due
Swedish Massage $60 _____ ________
Deep Tissue Massage $70 _____ ________
Hot Stone Massage $65 1 hr. _____ ________
$90 1 1/2 hr. _____ ________
Massage Packages (all package purchases must be used by one individual and include the value of a free session)
Price Qty Amnt Due
Stress Release Package $180 _____ _________
4 Swedish Massage sessions
Winter Warmth Package $190 _____ _________
4 Hot Stone Massage sessions
Work Out the Kinks $200 _____ _________
4 Deep Tissue Massage sessions
Try It All Package $180 _____ _________
1 Swedish Massage, 1 Hot Stone Massage, 1 Deep Tissue Massage, and your choice of Cupping/Cocoon Wrap or Detox Herbal Wrap
Reiki Package of 4 $160 _____ _________
Tender Care Package $276 _____ _________
6 Prenatal Massage sessions
New Mom Package $180 _____ _________
4 Postpartum Massage sessions _____ _________
TOTAL ORDERED ______ _________
Name:______________________________________________
Phone:___-____-_______
Address:_____________________________________________
City/Zip:____________________________
Enclosed: Check Credit Card Order: Visa or Master Card
To be: Mailed ___ or Picked Up ___
Account # ___________________________
Exp. Date:___/_____
