Information and Consent Form

Your Details

If you are under the age of 18 and have consent from a parent/guardian please make sure their infomration is filled out in the "additional contact" fields and that the signature below is of the parent/guardian.

Thank you. Please check your email for further information.

Please complete the information below. Once you have reviewed and accepted the terms and conditions you will be emailed with a confirmation of your appointment time and  request for payment requiring action before your session.