You may use this form to  change or cancel an existing appointment.
A $100 fee will be charged for appointments canceled with less than
48 hours notice.
Your first name:
Your last name:
Your email address:
Your phone number:
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Client name:
Appointment date:
Would you like to reschedule?  (Y/N):
Preferred day/time for
rescheduled appointment (you
may select more than one option
by holding down the Ctrl key):
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You may use the space below to clarify any information you
have submitted on this form.
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