Appointment Request
To request on appointment online, please fill in your personal
information and treatment choice below and click on Send request . Required
fields are marked with an red asterisk.
After your on-line appointment request is received,
you should receive an automated email reply. We will follow-up
with a phone call (or email if you requested this) to schedule
your treatments and appointment time.
Your Name (first & last)
Day Phone
Evening Phone:
Email
Please call during:
daytime
evening
email only
Address:
City:
State:
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
Zip Code:
I am interested in the following treatments:
(You may select a treatment from the list, or if you are unsure,
select the 'To be determined at appointment time' option instead)
To be determined at appointment time
Custom Brow Design
Brow Maintenance
Brow Tint
Lash Tint
Lip Wax
Full Face Wax
Brow and Lip Wax
Chin Wax
Facial Microdermabrasion
Facial Microdermabrasion with oxygen
Facial Microdermabrasion with DNA CryoStem™ cell
therapy
Facial Microdermabrasion with facial toning
Microdermabrasion Hands
Microdermabrasion Arms/Back
Microdermabrasion Declotte
Microdermabrasion Legs
Custom Facial with all natural organic products
Custom Facial with glycolic acid peel
Custom Facial with oxygen treatment
Oxygen Facial
Post-Operative Care with Oxygen
DNA CryoStem cell therapy
The Works
Facial Toning
Anti-wrinkle facial with neck & eye lift
Facial treatment plus add-on: Anti-wrinkle facial
Facial treatment plus add-on: Facial mask (collagen,
Vitamin C, seaweed)
Facial treatment plus add-on: Neck or eye lift
Facial treatment plus add-on: Eye treatment
Facial treatment plus add-on: Hand treatment
Facial treatment plus add-on: Oxygen mist
Facial treatment plus add-on: DNA CryoStem™ cell
therapy
Facial treatment plus add-on: Hand treatment
Light Therapy
Light Therapy plus add-on: Hands
Light Therapy plus add-on: Declotte
Light Therapy plus add-on: Cellulite Treatment
Light Therapy plus add-on: Buttocks or Stomach
Blueberry, pumpkin or pomegranate peel
Blueberry, pumpkin or pomegranate peel and Microdermabrasion
Blueberry, pumpkin or pomegranate peel and Microdermabrasion
with Oxygen
Benefit peel
Benefit peel and Microdermabrasion
Purity peel
Deep herbal peel
Timeless peel
Please enter any special requests:
Appointments are available Wednesday - Saturday
Requested Date and Time
Select month
January
February
March
April
May
June
July
August
September
October
November
December
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
,
2008
2009
2010
2011
2012
10 A.M. to 11 A.M.
11 A.M. to Noon
1 P.M. to 2 P.M.
2 P.M. to 3 P.M.
3 P.M. to 4 P.M.
4 P.M. to 5 P.M.
Requested Date and Time
Select month
January
February
March
April
May
June
July
August
September
October
November
December
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
,
2008
2009
2010
2011
2012
10 A.M. to 11 A.M.
11 A.M. to Noon
1 P.M. to 2 P.M.
2 P.M. to 3 P.M.
3 P.M. to 4 P.M.
4 P.M. to 5 P.M.
Requested Date and Time
Select month
January
February
March
April
May
June
July
August
September
October
November
December
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
,
2008
2009
2010
2011
2012
10 A.M. to 11 A.M.
11 A.M. to Noon
1 P.M. to 2 P.M.
2 P.M. to 3 P.M.
3 P.M. to 4 P.M.
4 P.M. to 5 P.M.
