The following is an appointment request form. We cannot guarantee availability until your appointment has been confirmed by a spa representative. Your request will be answered within 24 hours.

If you have any questions or would like to contact the spa directly via phone, please call us on (02) 4993 8692.

Personal Details
Title*	Please select... Mr Mrs Ms Miss Dr
First Name*
Surname*
Male/Female*	Female Male
Daytime Contact No.*
Email*
Will you be a guest of Cypress Lakes Resort at this time?	Yes No
Check-In Date
Check-Out Date
Your hotel phone no. (for confirmation)

Face:
Type	Please Select Facial A La Carte (50 mins) - $110 Men's skin Fitness Facial (50 mins) - $110 Men's Skin Fitness Facial (80 mins) - $180 Youth Elixir Oxygen Therapy (50 mins) - $170 Collagen Booster Facial (50 mins) - $170 Collagen Booster Facial (80 mins) - $205 Organic Elements Facial (50 mins) - $140 Organic Elements Facial (80 mins) - $205 High Skin Refiner Facial (50 mins) - $175 High Skin Refiner Facial (80 mins) - $220 Active Concentrate Skin Therapy (80 mins) - $250 Enhancers - Eye Enhancer or Ampoule - $20 each Enhancers - Hand/Feet (only available with 80 min treatment) - $20 each
Time Range	8am-12pm 12pm-4pm 4pm-8pm
Preferred Date
Preferred Time
Additional Requests

Waxing & Tinting:
Type	Please Select Lash Tint - $30 Brow Tint - $20 Lip or Brow Wax - $20 Full Leg Wax - $75 Half Leg Wax - $45 Underarm Wax - $30 Bikini Wax - $40 Brazilian Wax - $65 Back Wax - $50
Time Range	8am-12pm  12pm-4pm  4pm-8pm
Preferred Date
Preferred Time
Additional Requests

Hands & Feet:
Type	Please Select Hand Spa (50 mins) - $110 Hand Spa with French Polish (65 mins) - $125 Pedi Spa (50 mins) - $110 Pedi Spa with French Polish (65 mins) - $125 Parrafin Enhancer (30 mins) - $30
Time Range	8am-12pm  12pm-4pm  4pm-8pm
Preferred Date
Preferred Time
Additional Requests

Body:
Type	Please Select Vichy Power Exfoliation (50 mins) - $135 Aromatic Salt Glow (50 mins) - $135 Firming Algae Body Wrap (80 mins) - $175 Cleopatra Steam Infusion (50 mins) - $165 Balancing Mud Moor Bath (80 mins) - $185 Herbal Volcanic Wrap (80 mins) - $205
Time Range	8am-12pm  12pm-4pm  4pm-8pm
Preferred Date
Preferred Time
Additional Requests

Bath Soaks:
Type	Please Select Mineral Mud Moor (30 mins) - $50 Cleopatra Milk Bath (30 mins) - $50 Re-Mineralising Aromatic Salt Bath (30 mins) - $50
Time Range	8am-12pm  12pm-4pm  4pm-8pm
Preferred Date
Preferred Time
Additional Requests

Tanning:
Type	Please Select Spa Spray Tanning (30 mins) - $55
Time Range	8am-12pm  12pm-4pm  4pm-8pm
Preferred Date
Preferred Time
Additional Requests

Body Massage & Healing:
Type	Please Select Swedish Massage (50 mins) - $110 Aromatic Massage (50 mins) - $125 Aromatic Massage (80 mins) - $180 Pregnancy Massage (50 mins) - $125 Pregnancy Massage (80 mins) - $180 Remedial Massage (50 mins) - $125 Remedial Massage (80 mins) - $180 Deep Tissue Massage (50 mins) - $125 Deep Tissue Massage (80 mins) - $180 Trigger Point Therapy (50 mins) - $125 Trigger Point Therapy (80 mins) - $180 Hot Stone Therapy (50 mins) - $150 Hot Stone Therapy (80 mins) - $200 Lymphatic Body Massage (50 mins) - $125 Lymphatic Body Massage (80 mins) - $180 Lymphatic Face Massage (25 mins) - $80 Heartworks Lomi Lomi Massage (50 mins) - $145 Heartworks Lomi Lomi Massage (80 mins) - $180 Kahuna Style Lomi Lomi Treatment Of Tranquillity (120 mins) - $220 Reflexology (50 mins) - $125 Watsu (50 mins) - $200 Reiki (50 mins) - $145 Reiki (80 mins) - $180 Ignite Your Spirit Healing (50 mins) - $145 Ignite Your Spirit Healing (80 mins) - $200
Time Range	8am-12pm  12pm-4pm  4pm-8pm
Preferred Date
Preferred Time
Additional Requests

Mini Spa Experiences:
Type	Please Select Skin Renewal (80 mins) - $200 Essential Elements (80 mins) - $200 Radiance Boost (approx 2 hours) - $240
Time Range	8am-12pm  12pm-4pm  4pm-8pm
Preferred Date
Preferred Time
Additional Requests

Spa Packages:
Type	Please Select Spa Fusion (approx 3 hrs) - $300 Pamper Package (approx 2 hrs) - $260 Ultimate Couples Package (approx 2 hrs) - $440 per couple
Time Range	8am-12pm  12pm-4pm  4pm-8pm
Preferred Date
Preferred Time
Additional Requests

Are you happy to receive news from time to time on promotions and special offers from The Golden Door?*	Yes No