Purchase a Gift Certificate

Your Name (this will be entered into the "From" field): *

Your Email Address (the gift card will be emailed to you) *

Recipient's First Name *

Recipient's Last Name *

Message:

Gift Certificate Amount *

$ 100

$ 135

$ 200

$ 500

Other amount

This gift certificate will be applied to the account of the recipient named in this form. Refunds are not made available for gifted services; transfers can be made upon request. The gift certificate expires in one year. The value of the gift certificate may be used to purchase services through Ithaca Myofunctional Therapy, LLC.

I consent to these terms and conditions that apply to the purchase of the gift certificate.

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