New Client Form

New Client Form

Please complete prior to booking your appointment
Name *

First Name Last Name
Phone Number *

Area Code Phone Number
Birthday: *

Month Day Year
Email *
example@example.com
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Card required on file for No-Show protection. *

Name on Card

Card Number

Exp. date (MM/YY) Security code

Zip code
How did you hear about us? *

Website Facebook Web search Instagram Referral-if so, who?
What service are you looking to get?
Please upload: Right, center, left profiles

Browse Files

Cancel of
What times work best for you?(PRIMARY choice)
CHOOSE ONE
What times work best for you?(SECONDARY choice)
CHOOSE ONE
Ideal appointment date: (at least 2 days in advanced)
What types of scents do you like
Allergic to anything? *
Please read and check the following: *

I hereby authorize Savvy Skin Aesthetics to process credit card payments from the credit card saved on file when booking. Clients must have a current and active credit card on file at all times or risk any future appointments being cancelled without notice. I understand credit care payments will not be processed without due cause, and this card will only be charged for missed, late, or no-show appointment fees without my approval. By signing our form, you give us permission to charge your card for the amount of services booked on or after this date. I agree to have my card charged a 50% non-refundable appointment fee deposit, and the other 50% is taken care of at appointment. 100% of service fee is charged if I CANCEL WITHIN 24 hrs or NO-CALL NO-SHOW, this charge cannot be used towards another service. Anything done greater than a 24- hour notice (or certain exceptions) will not be charged additionally. I understand that I must provide at least a 24+ hour notice to cancelling appointments. If full payment is not received to do cancellation, I must pay that invoice prior to booking another appointment at Savvy Skin. I understand that if I am 10-15minutes late a $10 fee will be added to my appointment. 15+ minutes late to an appointment, a $10 late fee will be added to that appointment fee and rescheduled as time is valuable. I understand that after 3 cancellations in a row risk, or 3 no-shows within a 12 month period, termination from Savvy Skin. I agree that I cannot refund or exchange any products purchased or service provided. I agree to disclose any concerning signs of sickness (particularly related to COVID-19) to my provider BEFORE my appointment. *Fee may be waved under circumstances- Thank you for being considerate to the health of our providers! I agree to consent to Savvy Skin Aesthetics to post any before/after pictures on any social media site! I understand and agree to follow any and all Savvy Skin Aesthetics policies.
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