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Sessions by Appointment Only

Please fill out the form below to be added to my customer list. You may also use this form to schedule appointments and order gifts. Use comment section to request desired date and time.


A valid email address is necessary in order to generate a response to your request.

(please note response to appointment request will generate from info@alternativeclinicaltherapy.com. Add this address to your email contacts to avoid response routing to junk mail folder)

All major credit / debit cards accepted, as well as, cash and checks.

NEW CLIENTS ACCEPTED BY REFERRAL ONLY. Please indicate your reference contact in comment section.

It will be my pleasure to serve you!

SALON CLIENTS: Please indicate the name of referring stylist.

First Name: *

Last Name: *

Company:

Email: *

Phone:

Address 1:

Address 2:

City:

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Zip:

Comments: *


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