Waiting List

Please complete the fields below to be added to my waiting list:

Name

First Name

Last Name

Email address

Phone

(###)

###

####

How would you prefer to be notified of an available appointment?

Text message

Do you currently have an appointment scheduled with me that you'd like to reschedule if something else becomes available?

What days/times are you available for your appointment?

Be as specific as you can.

Which appointment session(s) are you interested in scheduling?

Any additional information you'd like to add: