Schedule Appointment with Blissfusion Wellness Lounge

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Last Name *

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Notes to Business (your address or any special notes about your order)

Item	Quantity	Total
Gift Certificate $100		$100.00
Total: $100.00	Coupon:

I agree to a 30-day written notice prior to cancellation for all purchased memberships made available to me at Blissfusion. Should I not provide appropriate notice, my card will be charged the membership fee associated with my package until proper notice is provided. **All notices must be received in writing 30-days prior to the date in which your card will be charged.