Appointment Request!

 

Use this Form to Request an Appointment via email

First Name
Family Name
Email Address
Phone
Will this be your first visit to Banyan Retreat?	Yes No
When would you like your treatment?	Click Here to select date
Approx Time:	Select Time 10:00 10:30 11:00 11:30 12:00 12:30 13:00 13:30 14:00 14:30 15:00 15:30 16:00 16:30 17:00
Therapist:	Select One Nic Steven Florence Lizzie Gail Robert Sheila
Treatment:	------
Special requests or additional information:
Please complete the following:

 

You will receive email confirmation of your request immediately,
followed by a reply from our reception staff within 24 hours - Thank you.