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Appointment Request

Please fill out the following form
in order to request an appointment. 

Please note that acceptable forms of payment are cash, credit/debit card and HSA/FSA cards.

We do not accept insurance.

Reason for Visit (Required)

Please let me know your preferred day and time of the week that you would like to book your appointment within our operating hours of Monday-Friday, 9 a.m. - 4 p.m.), and any additional info that you'd like me to know:

To secure your appointment, please submit a $50 deposit by clicking on the button below which will bring you to the payment page. Please note that this deposit is non-refundable, but will be applied towards your $249 initial consultation fee. A remaining $199 charge will be due at the time of your consultation appointment. If you are booking for Botox or a Wellness Boost Shot (in office injection), the deposit will be applied toward the cost of your treatment. Once your form and payment are received, we will contact you within 24 hours to arrange an appointment date and time that works best for you within our operating hours.

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