Request An Appointment

Please fill out the form below to request an appointment.  I'll either confirm it or suggest another time within 48 hours. 
Name:
Referred By:
Phone:
Email:
Date/Time:
Service(s):
Comments:

Cancellation Policy:  I value and appreciate your time spent in my chair.  My success depends on you showing up for your scheduled appointments on time.  When you are unable to keep a scheduled appointment, please call or email me 24 hours in advance to avoid a cancellation fee which may run up to 50% the value of your scheduled appointment.  Thank you for your understanding. 
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