Booking Deposit Form

Use the secure booking form below to pay your $100 booking fee deposit via credit card. You will receive a receipt of payment and instructions in the confirmation email.

By signing this form you agree to abide by our 48 hour cancellation policy. If you fail to cancel your appointment within 48 hours OR fail to show up to your scheduled appointment, you will forfeit this payment.

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Glow Medical Deposit Form

Your Name(Required)

First Last

Your Email Address(Required)

Email Address Confirm Email Address

$100 booking fee deposit

Price: $ 100.00 CAD

Total

Credit Card(Required)

Card Details

Cardholder Name

Billing Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

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Booking Deposit Form

Use the secure booking form below to pay your $100 booking fee deposit via credit card. You will receive a receipt of payment and instructions in the confirmation email.

Glow Medical Deposit Form

Glow Medical Aesthetics

West Lethbridge's Advanced Skin Care Team

West Lethbridge's
Advanced Skin Care Team