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Thank you for Scheduling Your Appointment Today.
Why wait any longer to achieve ultimate happiness?
Name
*
First
Last
Email
*
Please provide best Email to confirm appointment.
Please Re-Type Email below to Confirm
Phone
*
###
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###
-
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Please Indicate Purchase Method Below:
*
Please select
Purchasing Direct & Saving Extra Money!
Already purchased through Groupon or Living Social
Tips and Full payment available through VenMo, CashApp, PayPal and Zelle
Preferred Appointment Day
Day of Week: First Choice
Please select
Monday
Tuesday
Wednesday
Thursday
Friday
First Available/Any Day
Day of Week: Second Choice
Please select
Monday
Tuesday
Wednesday
Thursday
Friday
First Available/Any Day
Please enter preferred appointment times above.
Preferred Time of Time
Time: First Choice
Please select
Between 12:00 P.M. to 2:15 P.M.
Between 2:30 P.M. to 4:45 P.M.
Between 5 P.M. to 6:45 P.M.
Between 7 P.M. to 7:30 P.M.
First Available/Any Time
Time: Second Choice
Please select
Between 12:00 P.M. to 2:15 P.M.
Between 2:30 P.M. to 4:45 P.M.
Between 5 P.M. to 6:45 P.M.
Between 7 P.M. to 7:30 P.M.
First Available/Any Time
Please enter preferred time of day above.
Time Zone Verification
To coordinate appointment, please enter the exact time as you are submitting this form AND your time zone please. I am located in Connecticut via EST (Eastern Standard Time)
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