Client Info+Rescheduling Availability Update 2020
Please fill out the following so we can update our records.
Email address *
Do you want email appointment reminders? *
Required
First name *
Last name *
Cell number *
Preferred contact method *
Required
Would you like text appointment reminders ? *
Required
We are typically only open Tuesday-Saturday, on the off chance we add days and hours, please answer for all 7 days.
Please select all days and times that you are generally available. *
9AM-1PM
12PM-4PM
3PM-7PM
NONE
MONDAY
TUESDAY
WEDNESDAY
THURSDAY
FRIDAY
SATURDAY
SUNDAY
Preferred staff members- check all that apply to expedite appointment availability upon re-booking *
Required
Birthday- Month and day only :-) *
MM
/
DD
A copy of your responses will be emailed to the address you provided.
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy