Fairview Cosmetic Services Appointment Request Form
Fill out the request form below and we will contact you to confirm your appointment time. We will follow up with you via telephone or email during one of these times Monday 2 p.m. - 6 p.m., Tues 10 a.m. - 6 p.m., Wednesday 9 a.m. - 6 p.m., Thursday - 10 a.m. - 6 p.m.

To request an appointment over the phone, please call 952-826-6576.
First Name:
Last Name:
Address:
City:
State:
Email:
Phone Number:
(Format:###-###-####)

Appointment details:  

Preferred appointment time:

Please choose Monday, Tuesday, Wednesday, or Thursday and identify whether you prefer the morning or afternoon.