Priority Waitlist Form
  • Appointment Request Form

    If an appointment is available at your requested time you will receive a text message to book the slot you requested.
  • Format: (000) 000-0000.
  • Available days are Tues, Weds, Fri, Sat ONLY (Times Available for request: 10:30am, 12:30pm, 1pm, 3;30pm, 5:30pm, 7pm)*
     - -
  • Are you available for a different time slot than the one listed above?
  • Should be Empty: