Name *

First Name

Last Name

Phone *

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What services are you interested in? *

IV therapy: Immune Boost

IV therapy: Detox and Hangover

IV therapy: Energy Boost

IV therapy: Fat Burner

IV therapy: The Sanctuary Cocktail

IV therapy: Migraine Recovery

IV therapy: Hydration

IV Half Bag: Energize

IV Half Bag: Pain Relief

IV Quick Push: Nausea Relief add on

IV Quick Push: Diabetes/Liver Aid Add on

Injections: B-12 Booster

Injections: Pain Buster add on

Injections: Nausea Buster add on

Injections: Fat Burner

Swedish Massage 90 Minutes

Swedish Massage Full Hour

Swedish Massage Half Hour

Swedish Massage 15 Minute

Kinesiology/Muscle Testing

EFT/Tapping

Trapped Emotion Clearing

Reiki Half Hour

Migraine Rescue Package

Healy Frequency Therapy

Sound Bed Healing Full Hour

Sound Bed Healing Half Hour

Lymphedema Pumps

Cephaly Migraine Device

E-Stim Treatment

Massage Chair Half Hour

Massage Chair Full Hour

Foot Care

Ionic Detox Foot Soak

Alpha-Stim Depression/Anxiety Treatment x 4 sessions minimun

Energy/ Chakra Reading & Balancing

Facial Massage & Cryotherapy 15 Minutes

Facial Massage & Cryotherapy 30 Minutes

Medical Inutitive Reading

Soul Reading

Energy Migration

Manifestation Jar Workshop

Preferred Date

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Time

Hour

Minute

Second

AM PM