Please select available slot and fill the details.

First Name*
Last Name*
Email*
Phone*
Optional Note
Acceptance*
  • No children under 18 years of age.
  • No pets, only specifically trained service animals. Service animals are not allowed in the procedure room and must wait in the lobby. We are not responsible for any service animals left in the lobby.
  • No caffeine or alcohol within 24 hours of the procedure.
  • If you are over 10 minutes late to your appointment you will be considered a no show and your deposit will be forfeited.
  • Only one person allowed in the procedure room at a time.