Float Therapy Membership Cancellation Form
Please complete this form to request the cancellation of your float therapy membership. All fields are required to process your request efficiently.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Membership ID or Reference Number
Preferred Cancellation Effective Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Reason for Cancellation
*
Please Select
No longer using the service
Moving away
Financial reasons
Dissatisfied with experience
Other
If you selected 'Other', please specify
Additional Comments (optional)
I confirm that I wish to cancel my float therapy membership and understand this action is final.
*
I confirm my cancellation
Submit Cancellation
Should be Empty: