PEMF Therapy scheduler:
Please fill out this form to Schedule your PEMF Appointment
Full Name
*
First Name
Last Name
Address of your Horse/ Dog
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
E-mail
*
example@example.com
How did you hear about us?
Please Select
Facebook/IG
Google
A Friend
Other (Please specify...)
Your Horse/ Dog's History:
*
Other information I should know:
Has your horse/dog had PEMF Before?
*
Yes
No
If your horse/ dog has had PEMF Before- When was their last session? (MO/YR)
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Reserve your Appointment Time
Please chose 2 Dates and times below that will work best for you: I will call or text you within 2 Business days to confirm a date and time.
Date Reservation
Time
Hour Minutes
AM
PM
AM/PM Option
Date Reservation
Time
Hour Minutes
AM
PM
AM/PM Option
My Products
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PEMF Single Session
Scheduling requires a $20 NON-refundable Payment to Reserve your appointment time. (I will deduct this cost from your Bill at the appointment in place of Travel charges.)
$
20.00
Submit
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