Please complete and submit this form to book an appointment online and we will respond to your inquiry promptly. *Please note: times specified may not be available; times are not confirmed until you recieve a call from a SpaHampton representative confirming your appointment. First Name: Last Name: Address: Address: (cont'd) City: State: AL AK AZ AR CA CO CT DC DE FL GA HI ID IL IN IA KS KY LA MA MD ME MI MN MO MS MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY Zip Code: Email: Phone: Fax: Requested date of appointment: (mm/dd/yyyy) Time of appointment: Select a time 10:00am 11:00am 12:00pm 1:00pm 2:00pm 3:00pm 4:00pm 5:00pm 6:00pm What services are you interested in? sunshine packages massage body treatments facial makeup nailcare weddings waxing How many will be in your party? If children, specify their ages separated by commas: Please help us better understand your needs by filling in any additional notes in the box below:

OCEAN RESORT SPA Westhampton Bath & Tennis Hotel 231 Dune Road Westhampton Beach, NY 11978 Phone: 631-288-2500 Ext. 2841 Hotel Phone: 631-288-4900

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