EAST TO WEST THERAPEUTICS AND BODYWORK
HOME
BOOK NOW! 24/7 Online Booking
Location & Hours
Rates and Discounts
Email John
Photos
About
Who and How
BASIC Info for Newbies
Benefits of Bodywork and Accupressure
Bodywork at East To West
Types of Asian Bodywork
Therapeutic Massage
Deep Tissue
Chair Massage
Trigger Point Therapy
Cupping
Opinions and Comments
Traditional Chinese Medicine & Oriental Medicine
Reviews
Refer A Friend Submission Form
This form is for the
simple referral program
and any limited time promotional discounts being offered. If your form is submitted in the promotional window advertised, it will automatically qualify for that promotion or the simple referral program,
but not both
.
Please fill out the form below AFTER READING THE THREE STEPS:
1)
Start with YOUR name and email
(You may add your birthday as an option if you wish to receive additional discounts when your birth month arrives)
2)
Enter the name(s) and email(s) of the people you are referring
3)
Sit back and let the discounts roll in!
(But if you want to boost your chances, send them an email, text or make a call to let them know they have good things to look forward to.)
The following fields are
information about YOU
:
*
Indicates required field
YOUR Name
*
First
Last
Name of the current client of East To West Therapeutics, LLC
YOUR Email
*
When possible, please use your existing email with us to avoid duplicate entries
YOUR Birth Month
*
January
February
March
April
May
June
July
August
September
October
November
December
Choose your birth month
YOUR Birth Day
*
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Choose the day of your birth in that month
The following is for the people you are going to refer
.
Have more than 3? Call us and we will send an embarrassingly large car to pick you up for your appointment after they have enjoyed our services.
Referral #1
Name
*
First
Last
Email
*
Phone Number
*
Comment/Notes on this person? (e.g. My mom, my boss, etc.)
*
Referral #2
Name
*
First
Last
Email
*
Comment/Notes on this person? (e.g. My mom, my boss, etc.)
*
Phone Number
*
Referral #3
Name
*
First
Last
Email
*
Phone Number
*
Comment/Notes on this person? (e.g. My mom, my boss, etc.)
*
Submit
HOME
BOOK NOW! 24/7 Online Booking
Location & Hours
Rates and Discounts
Email John
Photos
About
Who and How
BASIC Info for Newbies
Benefits of Bodywork and Accupressure
Bodywork at East To West
Types of Asian Bodywork
Therapeutic Massage
Deep Tissue
Chair Massage
Trigger Point Therapy
Cupping
Opinions and Comments
Traditional Chinese Medicine & Oriental Medicine
Reviews