Consultation Form

Choose Your Mesmerized Moment Choose Your Mesmerized MomentCelebration Dinner Table DecorConcierge Service / DeliveryDate NightProposal CoordinationRomantic Decor

Your Name

Phone

Email Address

Best Time To Contact You? Best Time To Contact You?MorningAfternoonEvening

What Date is Your Mesmerized Moment?

Your Significant Others Name

What’s the Special Occasion? What’s the Special Occasion? Anniversary Birthday Proposal Just Because Other

For an additional $50, would you like for your concierge to research and book your hotel suite for you?

Do you know where you would like for your special occasion to take place? If so, where?

What do you envision as the perfect romantic night for your significant other?

Here are some special A LA Carte Services we offer Here are some special A LA Carte Services we offer Car Service Flower Arrangement Favorite Snacks Framed Photos Fruits Musician or Vocalist Personal Masseuse Photographer Private Chef

What time/date would you need the facility to be completed and decorated? (Please allow concierge 2.5 - 3 hrs for setup prior to your arrival ) *

Do you need for your Concierge to go & purchase gifts for your significant other?

What is your significant other’s favorite color?

Do you or your significant other have food/floral allergies? If so, please specify *

Do you have any “Must haves” that will make this night complete? If so, what are they?

For additional cost, would you like to discuss having your space decorated in a specific theme? For additional cost, would you like to discuss having your space decorated in a specific theme? Yes No