La Casa de Lilas - Reservation

FIRST NAME:

LAST NAME:

PHONE:

EMAIL:

ARRIVAL DATE:

SURGERY DATE:

DEPARTURE DATE:

DOCTOR´S NAME:

PROCEDURE:

COMENTS:

PICKUP:

Two Nights Minimum stay is required and please let us know of any special diet, including allergies

Method of Payment

To confirm a reservation a $150.00 warranty deposit is required. It will be applied to your first recovery night. We don't reimburse warranty deposits, but will apply it to your next reservation if your surgery is rescheduled within the following 3 months. The balance is paid upon arrival. All deposits and final payments have to be made with a money order, cashier's checks or cash.

WE ACCEPT CREDIT CARDS VISA AND MASTER CARD.