First Name *
Last Name *
Email Address *
Primary Phone # *
Cell Phone # *
I am a Please SelectNew PatientExisting Patient
Medi Spa Service(s) Please SelectBotoxFacial FillersMicroneedlingFacialPeelPRP "Vampire" FacialSkin ResurfacingSkin TighteningVein or Spot RemovalHair RemovalBrow / Lash TintingCuppingSalt Body GlowOther or Unsure
Plastic Surgery Consultation Please SelectBreast AugmentationBreast ReductionTummy TuckLiposuctionFaceliftNose JobNeck LiftArm LiftThigh LiftOther
Preferred Appointment Day Please SelectMondaysTuesdaysWednesdaysThursdaysFridaysSaturdays
Preferred Appointment Date
Preferred Appointment Time Please Select9am10am11am12noon1pm2pm3pm4pm5pm (Tues & Thurs Only)6pm (Tues & Thurs Only)
I understand that this is a request for an appointment only - and that the date & time must be confirmed by Aurora Medi Spa. *
Message, Question or Other Details *
0 + 3 = ? Please prove that you are human by solving the equation *
THIS IS A REQUEST FOR APPOINTMENT ONLY
YOUR APPOINTMENT IS NOT SET UNTIL CONFIRMED BY OUR STAFF
For your security & HIPAA compliance please do not submit privileged, confidential and/or protected health information.
Monday, Wednesday, Friday
9:00 a.m. – 5:00 p.m.
Tuesday & Thursday
9:00 a.m. – 7:00 p.m.
9:00 a.m. – 4:00 p.m.
2111 Merritt Rd -East Lansing, MI 48823