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Date: Thu, 23 May 2024 13:09:09 +0000
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Reply-To: sereniah@hotmail.com
Subject: Elements Laser Spa - Austin, Texas [#6656]
From: "Elements Laser Spa" <no-reply@wufoo.com>
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<table class="readonly" cellspacing="0" cellpadding="0" style="width:100%;border-bottom:1px solid #eee;font-size:12px;line-height:135%;font-family:'Lucida Grande','Lucida Sans Unicode', Tahoma, sans-serif">
	<tr class="radio" style="background-color:#F5F5F5">
		<th style="vertical-align:top;color:#222;text-align:left;padding:7px 9px 7px 9px;border-top:1px solid #eee;">
			Schedule Appointment or Make Inquiry?
			<span class="req" style="color:red">*</span>		</th>
		<td style="vertical-align:top;color:#333;width:60%;padding:7px 9px 7px 0;border-top:1px solid #eee;">
			<div>Schedule Appointment (new client)</div>
		</td>
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	<tr class="radio" style="background-color:#FFFFFF">
		<th style="vertical-align:top;color:#222;text-align:left;padding:7px 9px 7px 9px;border-top:1px solid #eee;">
			Select a Location
			<span class="req" style="color:red">*</span>		</th>
		<td style="vertical-align:top;color:#333;width:60%;padding:7px 9px 7px 0;border-top:1px solid #eee;">
			<div>NORTH</div>
		</td>
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	<tr style="background-color:#F5F5F5">
		<th style="vertical-align:top;color:#222;text-align:left;padding:7px 9px 7px 9px;border-top:1px solid #eee;">
			Name 
			<span class="req" style="color:red">*</span>		</th>
		<td style="vertical-align:top;color:#333;width:60%;padding:7px 9px 7px 0;border-top:1px solid #eee;">
		<span class="fn n">
			<span class="given-name" style="padding:0 5px 0 0">Sereniah</span>
			<span class="family-name">Breland</span>
		</span>
		</td>
	</tr>
	<tr style="background-color:#FFFFFF">
		<th style="vertical-align:top;color:#222;text-align:left;padding:7px 9px 7px 9px;border-top:1px solid #eee;">
			Email 
			<span class="req" style="color:red;">*</span>		</th>
		<td style="vertical-align:top;color:#333;width:60%;padding:7px 9px 7px 0;border-top:1px solid #eee;">
		<a class="email" href="mailto:sereniah@hotmail.com">sereniah@hotmail.com</a>
		</td>
	</tr>
	<tr style="background-color:#F5F5F5">
		<th style="vertical-align:top;color:#222;text-align:left;padding:7px 9px 7px 9px;border-top:1px solid #eee;">
			Phone Number 
			<span class="req" style="color:red">*</span>		</th>
		<td style="vertical-align:top;color:#333;width:60%;padding:7px 9px 7px 0;border-top:1px solid #eee;">
		<span class="tel">(405) 227-2577</span>
		</td>
	</tr>
		
	<tr class="location" style="background-color:#FFFFFF">
		<th style="vertical-align:top;color:#222;text-align:left;padding:7px 9px 7px 9px;border-top:1px solid #eee;">
			Address 
			<span class="req" style="color:red;">*</span>		</th>

		<td style="vertical-align:top;color:#333;width:60%;padding:7px 9px 7px 0;border-top:1px solid #eee;">
								<a target="_blank" title="Show a Map of this Location" style="text-decoration:none;"
			href="http://maps.google.com/?q=202 S 3rd street ++Pflugerville +Tx+78660+United States">
						<img class="mapicon"
						src="https://static.wufoo.com/images/icons/map.png"
						alt="" style="padding:2px 0 0 0;float:left;" width="16" height="16" />
			</a>			<address class="adr" style="color:#333;font-style:normal;line-height:130%;padding:2px 0 2px 25px;">
				<span class="street-address">202 S 3rd street </span>
				<span class="extended-address"></span>
				<br />				<span class="locality">Pflugerville </span>, 				<span class="region">Tx</span>
				<span class="postal-code">78660</span>
				<br />				<span class="country-name">United States</span>
			</address>
				</td>
	</tr>
	<tr style="background-color:#F5F5F5">
		<th style="vertical-align:top;color:#222;text-align:left;padding:7px 9px 7px 9px;border-top:1px solid #eee;">
			Birth Date 
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		<td style="vertical-align:top;color:#333;width:60%;padding:7px 9px 7px 0;border-top:1px solid #eee;">
		<abbr class="dtstamp" title="19770603" style="font-style:normal;border:none;">Friday, June  3, 1977</abbr>
		</td>
	</tr>
	<tr style="background-color:#FFFFFF">
		<th style="vertical-align:top;color:#222;text-align:left;padding:7px 9px 7px 9px;border-top:1px solid #eee;">
			Preferred Date 
			<span class="req" style="color:red;">*</span>		</th>
		<td style="vertical-align:top;color:#333;width:60%;padding:7px 9px 7px 0;border-top:1px solid #eee;">
		<abbr class="dtstamp" title="20240613" style="font-style:normal;border:none;">Thursday, June 13, 2024</abbr>
		</td>
	</tr>
	<tr style="background-color:#F5F5F5">
		<th style="vertical-align:top;color:#222;text-align:left;padding:7px 9px 7px 9px;border-top:1px solid #eee;">
			Preferred Time 
			<span class="req" style="color:red">*</span>		</th>
		<td style="vertical-align:top;color:#333;width:60%;padding:7px 9px 7px 0;border-top:1px solid #eee;">
			<div>Evening</div>
		</td>
	</tr>
	<tr style="background-color:#FFFFFF">
		<th style="vertical-align:top;color:#222;text-align:left;padding:7px 9px 7px 9px;border-top:1px solid #eee;">
			Skin Tone 
			<span class="req" style="color:red">*</span>		</th>
		<td style="vertical-align:top;color:#333;width:60%;padding:7px 9px 7px 0;border-top:1px solid #eee;">
			<div>Light</div>
		</td>
	</tr>
	<tr style="background-color:#F5F5F5">
		<th style="vertical-align:top;color:#222;text-align:left;padding:7px 9px 7px 9px;border-top:1px solid #eee;">
			Hair Color 
			<span class="req" style="color:red">*</span>		</th>
		<td style="vertical-align:top;color:#333;width:60%;padding:7px 9px 7px 0;border-top:1px solid #eee;">
			<div>Blonde</div>
		</td>
	</tr>
	<tr style="background-color:#FFFFFF">
		<th style="vertical-align:top;color:#222;text-align:left;padding:7px 9px 7px 9px;border-top:1px solid #eee;">
			Service Required (North) 
			<span class="req" style="color:red">*</span>		</th>
		<td style="vertical-align:top;color:#333;width:60%;padding:7px 9px 7px 0;border-top:1px solid #eee;">
			<div>IPL PhotoFacial / IPL Body</div>
		</td>
	</tr>
	<tr style="background-color:#F5F5F5" >
		<th style="vertical-align:top;color:#222;text-align:left;padding:7px 9px 7px 9px;border-top:1px solid #eee;">
			Referral Source 
			<span class="req" style="color:red">*</span>		</th>
		<td id="roField131" style="vertical-align:top;color:#333;width:60%;padding:7px 9px 7px 0;border-top:1px solid #eee;">
			<div>Groupon</div>
		</td>
	</tr>
	
			<tr style="background-color:#FFFFFF">
			<th style="vertical-align:top;color:#222;text-align:left;padding:7px 9px 7px 9px;border-top:1px solid #eee;">
				Comments
							</th>
			<td style="vertical-align:top;color:#333;width:60%;padding:7px 9px 7px 0;border-top:1px solid #eee;">
				<div>I had requested appt but not sure it has been confirmed. Can you advise on June 13 at 5pm? Thanks!</div>
			</td>
		</tr>
	
</table>

 



 


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