Please complete the form below once your appointment date and time has been confirmed. By filling out this form you agree to be charged $50 on the card provided. The $50 charge will be used to reserve your appointment. It will then be used as credit towards your scheduled treatment. Your scheduled appointment is reserved exclusively for you. Should you need to cancel or reschedule your appointment, please notify us 24 hours in advance to avoid an additional charge of 50% of your treatment. All services re-scheduled or cancelled on same day of appointment or missed without notice will be charged 100% of treatment price.