Schedule Your CelluSleek™ Body Treatment

Age

Preferred Date/Time

Are you a current client?

If not, how did you hear about us?

Which areas of your body have cellulite or unwanted inches?

Rate the appearance of Cellulite seen in these areas: *See Stages Diagrams Below*

On a scale of 1-10 how badly does cellulite and unwanted inches bother you?

What is one thing you are prevented from doing because of your cellulite and unwanted inches?

Stage 1

Stage 2

Stage 3

Stage 4