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Appointment Request

Please feel free to fill out the following form with your request.  We require minimum two days and times for appointment request.  Allow at least minimum 24 hours to confirm your appointment request. Be aware that unless you receive a call or email from our therapist, a request is not valid or confirmed.

Please note that all fields followed by an asterisk must be filled in.*

 

First Name*
Last Name*
Sex Male Female

 

Email Address*

Please Provide a Phone Number Where Our Massage Therapist can reach You to set up your Appointment:

Telephone #*

xxx-xxx-xxxx

Date of Requested Appointment :           

-- mm/dd/yy       

Time of Requested Appointment ... :

xx:xx

Please choose which massage treatment  or service you prefer:

Treatment or Service:

Questions or comments?

 

 

   

 

 

 

Massage Services

Face

 Package Discounts

ThetaHealing®

Intuitive Life Coaching

Lypossage 

Postural Correction

 LightWave Skin Therapy 

Resonance Repatterning

Gift Certificates

Beyond Bliss

Cancellations

Kelli Mirr, LMT & Lypossage™ Practitioner

By appointment only

(954) 924-8878 or Send Request

Sheridan Executive Center

3475 Sheridan Street ·  #215E ·   Hollywood, Fl 33021

MM32345  MA28886

  Directions To This Location

**Ask about the health and beauty benefits of KANGEN alkaline water and enjoy some at your next appointment."

 

 

                                       

 

 All information contained herein is subjective; based on opinion, not fact. Services provided are not meant to substitute for medical attention. Referrals available upon request.

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