Special Appointment Request Form

If you require an appointment a date outside of what is available, please fill out the special request form below.

If you are a higher risk individual due to health concerns (ie. pre-existing condition, chronic illness, immunocompromised, elderly, etc.), we are happy to coordinate special accommodations for you to make your visit as safe as possible.


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Are you a regular client or a new client?(required)

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Preferred method of contact:(required)

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