New Patient Request Form

Confirm that you agree to our terms of service and cancellation policy by checking this box.

By submitting this form, I acknowledge and agree to the following terms:

Client Acknowledgment and Agreement

1. A $100 non-refundable consultation fee is required. This may be applied toward treatments purchased on the same day or keep it as a deposit for future appointments. If no treatment is purchased on the same day, the fee will serve as payment for the consultation and professional guidance provided.

2. A $100 treatment deposit is required for each booked service. The deposit may be applied toward the cost of the treatment or toward a future appointment.

3. We enforces a strict 48-hour cancellation policy. Cancellations made within 48 hours of the scheduled appointment, as well as no-shows, will result in forfeiture of the deposit. A new deposit will be required to reschedule the appointment.

4. Appointments are not considered confirmed until the required consultation fee or treatment deposit has been completed. A confirmation text will be sent once the payment has been received.

5. All packages must be paid in full at the time of booking, as treatments require advance planning and preparation.

All information provided is accurate to the best of my knowledge and will be kept strictly confidential.