Date Requested:

Requested By:

Email (this is how we will communicate):


Organization Name:

Event Name:

Date of Event:

Special Instructions/Notes:

Completing this form does not guarantee that a basket will be available for your event. We make every effort to accommodate requests, but we can only fulfill 1 basket request per organization per year. Once approved, you will receive an email confirming the details and date of pick up. Most baskets are typically available for pickup 10 days prior to your event.

Pickup location is at Southside office, 7711 Baymeadows Rd E 32256.

Ponte Vedra Plastic Surgery proudly presents this beautifully decorated gift basket. As the winner, you receive a certificate for 1 complimentary consultation with one of our board certified physicians, which is valued at $100, as well as $100 towards any one skincare service of your choice. This basket also contains a variety of our own PVPS spa products, such as a moisturizer, body scrub, body wash, and much more! These exclusive products will not only protect your skin, but leave you feeling like you just stepped out of a spa. Your basket is graciously provided to you by the Skin Care Department at Ponte Vedra Plastic Surgery.  

This basket is valued at $350.00 To redeem your gift certificates, please call our office at 904-273-6200. Our friendly staff will be happy to assist you!

Please visit our website for more information

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