Request an Appointment

Your scheduled appointment time has been reserved specifically for you. We request 24-hours notice if you need to cancel your appointment. We are aware that unforeseen events sometimes require missing an appointment. After missing your second appointment without notifying us 24 hours in advance, you are subject to being charged a 100% cancellation fee.

Please fill out the information below and one of our team members will contact you to schedule an appointment time. Please note that this form does not secure or guarantee an appointment. Only when you have been contacted by a Haven representative will your appointment be confirmed. We look forward to seeing you soon.

*Client Name :**	Please enter your name.
*New Client :**	Yes No Please enter whether you are a new client or not.
*Email :**	Please enter a valid email address.
Address:
Phone: *	Please enter your phone number.
Preferred Days: *	Please enter preferred days.
Convenient Times: *	Please enter convenient times.
How did you hear about Haven?
How did you find our web site?:
*Desired Appointment :** Please enter desired appointment.
Comments:

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