New Customer Registration Form

  • Customer Details:

    Please fill out the form below and we will follow up with practitioner's availability.
  • Format: (000) 000-0000.

  • My Products

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      Choose Your Sessions

      If you qualify for sliding scale, we will adjust/refund the difference upon appointment confirmation.

      $100.00$100.00
      sliding scale Duration/packages. practitioner Price
      New Mexican Heritage $100.00$100.00
      Herbal deposit $150.00$150.00
      1.5 hours $225.00$225.00
      1.5 hour upper $275.00$275.00
      2 hour low scale $300.00$300.00
      2 hour upper $375.00$375.00

      Item subtotal:$0.00$0.00
        
      Subtotal
      $0.00$0.00
      Tax
      $0.00$0.00
      Total
      $0.00$0.00

    • Payment Methods

      Choose from one of the PayPal options to make your payment.

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