ONLINE APPOINTMENT

Thank you for your interest in Spa Asia. We strongly encourage you to make appointments before your arrival so we can meet your specific scheduling requests. When booking services, please advise the spa receptionist of any health conditions, allergies or injuries which could affect your service.

Please fill in this form and we will respond to your request for an appointment via e-mail or call detailing your appointment schedule. Please include as much information as possible to help us serve you better.

Please allow 48-72 hours for a response to an e-mail or call request. We will make every effort to accommodate your scheduling requests, however, your appointment request is not a confirmation. We will contact you by phone or email with a suggested appointment schedule. To confirm the appointments, you will need to provide us with a credit card number.

Contact Information

Service Request:	----Please Select---- BODY-Aromatherapy Body Massage BODY-Javanese Lulur BODY-Milk Bath BODY-Sea Salt Scrub BODY-Balinese Boreh BODY-Fruit Bath HEAD-Hair Créme Bath FACE-Aromatic Facial FACE-Collagen Facial HAND & FEET-Manicure Treatment HAND & FEET-Pedicure Treatment HAND & FEET-Callus Removing Treatment OTHERS-Waxing OTHERS-Eyebrow Trimming OTHERS-Bridal Makeup
*First Name:
*Last Name:
Gender:	Male Female
*Address:
City:
*State:	----Please Select---- SELANGOR KUALA LUMPUR PUTRAJAYA JOHOR KEDAH KELANTAN LABUAN MELAKA NEGERI SEMBILAN PAHANG PERAK PERLIS PULAU PINANG SABAH SARAWAK TERENGGANU
*Postcode:
*Contact Number:
Best Time to Call:	am pm
*Email:
	By submitting this form you are giving Mircoz Spa Asia permission to send you information from time to time by email. This will be strictly from Mircoz Spa Asia, and you will be able to have your address removed from the email list at any time, beginning with the first received email. We promise we are not interested in spamming any email address and will NEVER sell or trade your information.