Cancellation appeals

Please fill out the form below to appeal a cancellation fee decision. For more information, please review the Appeal of Cancellation Fee Policy here.

Name of Rocky Bay customer*
First Last
Name of person requesting reimbursement*
First Last
Phone Number*
Email*
Date of service*
MM slash DD slash YYYY
Time of service*
Services at Rocky Bay*
Reason for cancellation*
Please add supporting documentation if available
Max. file size: 64 MB.
Comments
This field is for validation purposes and should be left unchanged.