Spa Appointment Request Form

Title: Mr. Ms.

First Name:

Last Name:

Phone:

E-Mail:

Have you been to Shizuka New York Day Spa before?
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Select a Date:

Or enter a date (MM/DD/YYYY):

Select a preferred starting time: Earliest Available Time 10:00 AM (Sat Only) 10:30 AM (Sat Only) 11:00 AM 11:30 AM 12:00 PM 12:30 PM 1:00 PM 1:30 PM 2:00 PM 2:30 PM 3:00 PM 3:30 PM 4:00 PM 4:30 PM 5:00 PM 5:30 PM 6:00 PM (Mo - Fri Only) 6:30 PM (Mo - Fri Only) 7:00 PM (Tu - Fri Only) 7:30 PM (Tu - Fri Only) Latest Available Time

Please select treatments from the options below, as desired. Find spa packages here.

Facials:

Select a facial:   Acne Facial with IPL Classic Facial Classic Men's Facial Collagen Boost Facial Crystal Peel Microdermabrasion Facial Express Facial Geisha Facial GentleWaves Facial Ionizing Facial Lifting Facial Lightening Facial Lunchtime Peel Men's Toning Facial Microcurrent Facial Omedeta Maternity Facial Signature Anti-Aging Photo Facial Signature Micro Facial Total Skin Rejuvenation Peel

Enhance with:   Intense Pulsed Light for Acne Chest/Décolleté Facial Classic Facial Collagen Mask Enzyme Peel Facial Massage GentleWaves LED Treatment Microcurrent Facial Toning (Lifting) Light Microdermabrasion Pore Extraction

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Massage:

Select a massage:   AromaScape Massage (50 Min) AromaScape Massage (80 Min) Deep Tissue Massage (50 Min) Deep Tissue Massage (80 Min) Hot Stone Massage (50 Min) Hot Stone Massage (80 Min) Omedeta Maternity Massage (25 Min) Omedeta Maternity Massage (50 Min) Shiatsu Massage (25 Min) Shiatsu Massage (35 Min) Shiatsu Massage (50 Min) Shiatsu Massage (80 Min) Swedish Massage (35 Min) Swedish Massage (50 Min) Swedish Massage (80 Min)

Request a therapist (optional):

Check here for Couple's Massage (Select type and duration above)

Body Treatments:

Select a treatment:   Back "Facial" Body Scrub Chest "Facial" Coffee Break Mud Wrap

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Nail Spa:

Select a manicure:    Basic Manicure Classic Manicure Nagomi Manicure Crystal Manicure Disco-Ball Manicure Men's Manicure L.E.D. Gel Manicure Gel Manicure w/ Soak-Off    Enhance with:    French Tips Japanese Nail Art Swarovski Crystals Glitter (Gel) Gradation (Gel)

Select a pedicure:    Basic Pedicure Classic Pedicure Sakura Pedicure Espresso Mud Pedicure Crystal Pedicure Men's Pedicure L.E.D. Gel Pedicure Gel Pedicure w/ Soak-Off    Enhance with:    French Tips Japanese Nail Art Reflexology (10 min) Swarovski Crystals Glitter (Gel) Gradation (Gel)

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Eyelash Treatments:

Select a treatment:    Eyelash Perm Eyelash Extensions FULL Eyelash Tinting EyeBROW Tinting Eyelash + Brow Tinting Eyelash Extensions TRIAL Eyelash Extensions 30min Special Touch-up ($100) Extension Touch-Up 60 Min Extension Touch-Up 30 Min

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Hair Removal:

Method of Hair Removal:  Intense Pulsed Light  Electrolysis  Waxing

Hair Removal Area 1:    Abdomen Anal Area Arms (Forearms) Arms (Upper) Back (Full) Back (Lower) Back (Upper) Beard (Above Neck) Bikini BASIC Bikini BRAZILIAN Bikini AUSTRALIAN "Full Monty" Buttocks Chest Chin Eyebrow Legs (Thighs/Upper) Legs (Lower) Upper Lip Neck (Front) Neck (Back)

Hair Removal Area 2:    Abdomen Anal Area Arms (Forearms) Arms (Upper) Back (Full) Back (Lower) Back (Upper) Beard (Above Neck) Bikini BASIC Bikini BRAZILIAN Bikini AUSTRALIAN "Full Monty" Buttocks Chest Chin Eyebrow Legs (Thighs/Upper) Legs (Lower) Upper Lip Neck (Front) Neck (Back)

Hair Removal Area 3:    Abdomen Anal Area Arms (Forearms) Arms (Upper) Back (Full) Back (Lower) Back (Upper) Beard (Above Neck) Bikini BASIC Bikini BRAZILIAN Bikini AUSTRALIAN "Full Monty" Buttocks Chest Chin Eyebrow Legs (Thighs/Upper) Legs (Lower) Upper Lip Neck (Front) Neck (Back)

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