Cancellation Waitlist

Cancellation Waitlist

LIFE WELLNESS CENTER
The purpose of this form is to serve as a waitlist for any date/time that is not currently available.

Also, feel free to book your appointment and also add yourself to this waitlist if the time you prefer most is not open. We will give you a call to reschedule for your preferred time if/when it becomes available.

Our online booking does not allow for same day appointments. For same day appointments, please call in directly to 347-461-9939 and submit this form afterwards if there are no openings.
Name *

First Name Last Name
Phone Number *
Please enter a valid phone number.
Email
example@example.com
Primary Desired Date *

Month Day Year
Date
Secondary Desired Date

Month Day Year
Date
Describe Your Availability On Your Selected Date(s) *
Ex. I'm available on 10/16 from 10am-4pm, I'm available on...
Desired Appointment Type(s)

Swedish Restorative 50min Swedish Restorative 70min Swedish Restorative 90min Deep Tissue 50min Deep Tissue 70min Deep Tissue 90min Thai Yoga Massage (Mondays ONLY from 9am-2pm) Dual Massage & Acupuncture 70min Dual Massage & Acupuncture 90min Acupuncture Pre-Natal Massage Focus Massage Therapeutic Foot Massage Chiropractic (Thursdays ONLY from 9am-2pm)
*If any of your selected appointment types/lengths are available, we will reach out to you. Select as many as you wish.
Should be Empty:

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