NAMASTE SPA APPOINTMENT REQUEST

Please fill out the form below to request your appointment at Namaste Spa. Submission of this form does not guarantee requested dates, services or packages. A member of the Carpe Diem Team will contact you to confirm the details of your appointment.

Fields marked with * are required.

Contact Information

* First Name

* Last Name

* Street Address

Address Line 2

* City

State

* COUNTRY

* Zip Code

* Phone Number

* Email Address

* Credit Card Type

* Credit Card Number

* CSC Code

* Expiration Date (mm/yy)

*
CANCELLATIONS WITHIN 24 HOURS BEFORE TREATMENT WILL BE CHARGED IN FULL

I AGREE

YES

NO

Appointment Details

CLASSICS / SCRUBS & POLISHES

RATES FOR CLASSICS, SCRUBS & POLISHES

________________________________

ENERGY HEALING & EASTERN ARTS

RATES FOR ENERGY HEALING & EASTERN ARTS

________________________________

* Treatment Date

* Treatment Time

________________________________

PLEASE DO NOT SCHEDULE MULTIPLE TREATMENTS FOR THE SAME DAY & TIME.
ADDITIONAL TREATMENTS ON THE SAME DAY MUST BE SCHEDULED BEFORE OR AFTER
ABOVE SCHEDULED TREATMENT.

Comments

* Indicates Response Required