Ionic Spa appointment
WITH APPOINTMENT ONLY
Detoxification and purification with the ionic spa helps to restore our vitality which is affected by the toxins we find in our environment.
Complete the * sections. The information collected in this form will be used to complete your client's file.
I'm a new client :
(For new clients, there is a $10 file opening fee.)
Town / Village
Date of Birth :
DD = day, MM = month, YYYY = year
Exemple : 24/02/1975
My choice is :
Ionic spa (15 min) with foot massage (30 min) / ($55)
Ionic spa (30 min) with foot massage (3o min) / ($80)
Ionic spa 15 min ($25)
Ionic spa 30 min ($40)
I have allergies and/or intolerances to essential oils, incense, perfume or other.
If any, specify in Important note(s).
For my Ionic Spa appointment, I choose the following essential oil blend (in diffusion):
No Thanks! Not for me!
Important note(s) :
(pain, allergies, etc.)
Checkmark the moment to receive the massage.
Checkmark your preferences.
My method of paiment:
Interac credit transfer
For Interac credit transfer, use the following email: firstname.lastname@example.org
I need one. Thanks!
I don't need one.
Please use the following way to reach me :
For texting, please provide me a mobile phone number that Iwill be able to use to confirmat your massage appointment.
Online Payment Form