Linea Intima Appointment Request

Please use the form below to request an appointment and we will contact you as soon as possible to confirm your appointment request. Thank you.

What kind of appointment do you need?*

Professional Bra Fitting - 30 minutesBra Wardrobe Consultation - 1 hour (includes a Professional Bra Fitting + advise on building a bra wardrobe tailored to your needs)Mastectomy Fitting

Store Location*

Please choose the store where you would like to be fitted

Reservations needed*

Please select the number of reservations needed - Each Member of your party requires a reservation.

Full Name*

First NameLast Name

E-mail*

Daytime Phone Number*

Area CodePhone Number

Mobile Number

Area CodePhone Number

Preferred Date*

MonthDayYear

Preferred Time*

:HourMinutesAM/PM Option

Prefered method of contact?*

EmailPhoneEither is fine

Bra Size (if known)

Please enter the size of your bra you wear most often, ie. 38F

Panty Size (if known)

ie. bridal, mastectomy, etc.)Your answer

Specialty Needs (if any)

(ie. bridal, mastectomy)

Wish List

(brands/bathing suits etc.)

Other details you may wish to highlight

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Source

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