Book a Room

Luxury Living Booking Form

Fill the form below to book the room, and pay your deposit, once your deposit is made please expect emails from reservations@luxurylivingrecovery.com
Name*

First NameLast Name
E-mail*
example@example.com
Phone Number*
Date of Birth MM/DD/YYYY*
Room Type: ( Rate includes: 24 Hour Care for first 2 nights then 8 hours of daily care each day after, 3 Meals, Daily Snacks, Beverages, Laundry, Housekeeping, Basic Surgery Supplies, Prescription Pick Up, Transportation)*

Queen Private Room $600 per nightQueen Private Room with Private Bathroom $625 per night
Procedure(s):*
Surgery Center:*
Doctor Name:*
Surgery Date:*

MonthDayYear
Date
Pick Up Options?*

Early Check In (I'll Pay Fee$175)Check in at 4:00 pm or anytime after 4:00 pmSurgery Day Pick Up
Check In Date*

MonthDayYear
Check Out Date (check out is at 10:00am)*

MonthDayYear
Number of Nights*
Questions/ Special Request:

Non Refundable Deposit:*

USDGood for 6 months if need to reschedule

Credit Card

Apple Pay

Google Pay

Cash App Pay

Afterpay

Luxury Living Booking Form