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Relieve Clinic Appointment Form

Hello and welcome to Relieve Clinic, where we strive to eliminate pain from your journey to beauty.


Please fill out the form below, and we will contact you via WhatsApp with a confirmation message.

After reviewing availability for your requested date, we will get in touch to finalize your appointment. Your booking will only be confirmed once a time is set.


If you are visiting with two or more people, please have one representative complete the form on behalf of your group.


Please note that our customer service team is unavailable on Wednesdays and weekends.

We will do our best to get back to you as promptly as possible.

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Full Name (for more than one person, write everyone's full name down!)
Are you visiting our clinic for the first time?
* Please include the name and date of birth of the returning customer in the additional notes section! 😊*
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Whatsapp number (Please add country code) 
*Double check to see if it's right! We send confirmation message through Whatsapp! 
*If you don’t have WhatsApp, please provide your Instagram ID. (For quicker responses, WhatsApp is recommended!)  
Instagram ID 

If there’s no response on WhatsApp, I’ll follow up with an Instagram DM within a few days.

How did you hear about Relieve clinic? (e.g. friend referral, Instagram post, YouTube, blog, etc.) 
1st  Preferred Appointment Time
We don't open on Sundays 
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2nd  Preferred Appointment Time
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Preferred Time Slots
Mon-Fri 10:30-7:30pm (5:30pm is the last appointment)
Sat: 10:30-4:30 (2:30pm is the last appointment)
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Type of Consultation
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Interested Treatments (You can select multiple)
You can add on or decide treatments after the consultation
 Confirmation Agreement  
  I understand that my appointment is not confirmed until I receive a confirmation message on WhatsApp.  
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If you’re coming as a group, did one person fill in all group members’ names on the form? (If you're coming alone, please select 'Yes')
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If you’ve made a reservation, is it alright if we kindly ask you to contact us on WhatsApp for any questions or changes?
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Thank you! 

We will review the information you provided and contact you via WhatsApp once we have done so.

Please note that responses may be delayed on Wednesdays and weekends, but we will do our best to reach out to you as soon as possible.

Thank you for choosing Relieve Clinic, where we are committed to providing pain-free treatments on your journey to beauty.

We look forward to welcoming you soon.

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