SUBMIT APPOINTMENT REQUEST

Due to COVID-19, for the protection of your family and our employees, we are only scheduling one family at a time and require a $25 per person appointment retainer deposit to lock in your appointment so that we do not book another family. This deposit will be credited back towards the cost of your head screen or treatment when we check you out.

After you submit this form, a member of our customer care team will text you back within 15 minutes or less to confirm availability for your requested day and time. We will then text and email a link to pay your appointment retainer deposition directly through our square payment processing system so that we do not have to take down any of your credit card information over the phone.

Once the appointment retainer deposit is paid, we will confirm back to you that it has been received and then officially book your appointment in our system and email your appointment confirmation along with answers to common questions.

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Parent/Guardian Information

First Name

Last Name

Cell Phone

Name of family members that need to be treated for sure:

First & Last Name

Relationship

Age

First & Last Name

Relationship

Age

First & Last Name

Relationship

Age

Name of family members that need to be screened:

First & Last Name

Relationship

Age

First & Last Name

Relationship

Age

First & Last Name

Relationship

Age

Preferred day for appointment?

Clinic Text - Not Visible To Public

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SUBMIT APPOINTMENT REQUEST

TORRANCE LICE REMOVAL

TORRANCE LICE REMOVAL-THE SOUTHERN CA LICE EXPERTS