To request an appointment, please complete the form below or call (818) 551-1682 for Glendale, (213) 617-1682 for DTLA.  This form only accepts requests 2 days in advance, for earlier appointments please call one of our locations. 

    Appointment Location

    First Name

    Last Name

    Phone Number

    E-mail

    Which treatment are you interested in?

    Preferred Date/Time (optional)

    1st Preferred Date (within 30 days):

    1st Preferred Time:

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    2nd Preferred Date (within 30 days):

    2nd Preferred Time:

    Comments

    Optional - message or special request:

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