Skincare and Spa #team921cares (410) 783-7727 info@studio921spa.com

#team921baltimore 410-783-7727
DIGITAL SKINCARE CONSULTATION FORM

Please complete the information below to help make your spa experience as smooth and safe as possible!
Name *

First Name Last Name
Email *
example@example.com
Zip Code *
Phone Number *

Area Code Phone Number
Who is your requested Service Provider? *
Please list the type of service(s) you would like to have done at your upcoming visit. (ex. Custom Facial, Peel, Lash Lift, Dermaplane, waxing, Microblading, etc.) *
Please list at least 2 days/times you are available for your appointment. Are you flexible? *
What kind of at home products have you been using?

All professional products from 921 What I can find in my bathroom or the grocery store
What at home products can we help you with / have ready for you / order for you, during your visit? #supportsmall *
I agree to wear a mask during my visit . *

Yes
I agree and understand that if I am unable to make my appointment and do not cancel within 24 hours, I am subject to a $60 per hour fee, based on my booking time. *

Yes, I understand. I know a lot of guests are on waiting list.
I understand that some service prices may have been adjusted accordingly to compensate for increases including, but not limited to vendor costs, costs of goods, and safety equipment. *

Yes, I understand
I agree to wash my hands and use sanitizer upon arriving to the salon and practice social distancing. *

Yes, of course!
I understand I can not have another person, including children, with me at my appointment for health/safety reasons. *

Yes
I agree to call / email the salon (410) 783-7727 info@studio921spa.com upon my arrival, to notify them I am here for my appointment. *

Yes!
Health questionnaire

In order to protect our staff and our guests, please be sure to answer the below health questions honestly. These records are for our personal use only and will be asked again upon arriving to your visit.
Have you been knowingly exposed to COVID-19? *

Yes No
Have you or anyone in your household experienced symptoms of COVID-19 in the last 2 weeks? (high fever, cough, shortness of breath, chills, headaches, muscle pain, or sore throat?) *

Yes No
Have you or anyone in your household traveled outside the U.S in the last 30 days? *

Yes No
I understand, have read and completed this questionnaire truthfully. I agree that this constitutes full discolver and it supersedes that witholding information or providing misinformation may result in pricing contradictions and/or irritation to the hair service being received.
*

Yes, I understand and agree
Signature

Clear
Should be Empty:

#team921baltimore 410-783-7727

DIGITAL SKINCARE CONSULTATION FORM

Health questionnaire