Appointment Request Form

  • -Appointments are available Mon-Sat. from 9am to 5:00pm ONLY
    -Please Request Start Time on the Hour or Half Hour

Upon receipt and checking availability...

Darlene will send a separate email "Confirmation"

Your treatment will be at:

Nirvana Skin Wellness Center, 118 Maine Mall Road, South Portland, ME.

Please complete the following form to make a reservation request

Appointment Date? (Click Calendar Icon to pick Day)*
Appointment Time?:*
 : 
Treatment for...?*
Which treatment option?*
Notes to Darlene:
Your Contact Information*
Email Address
Phone*
-
Human Verification:

Important Note: Be sure to check your email SPAM Folder, and then, re-direct to "Inbox"!!!