Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Name *FirstLastPlease enter your preferred first name and your last name.Mobile Phone *Please enter a valid number that can receive SMS text messages for reminders from us. Email *Please enter a valid email address.Please select the spa service(s) you're interested in: *Cosmetic TreatmentMicroneedling/Skin TreatmentHormone Therapy/Testosterone EnhancerHair Restoration/RemovalWeight ManagementBody Contouring/Skin Tightening Please in: spa Government regulations require us to add the following request for consent to this form: *I consent to receive SMS notifications, alerts & occasional marketing communication from New River Medical Grade Spa. Message frequency varies. Message & data rates may apply. Text help to (540) 501-6794 for assistance. You can reply STOP to unsubscribe at any time.Submit Privacy Policy | Terms of Service Skip back to main navigation