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Information Request Form
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Name
First Name
Last Name
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2
E-mail
example@example.com
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3
Phone Number
Area Code
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4
What are you here for today ?
What is your highest concern or are you here for just relaxation ?
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5
You agree that you have complete understanding of the service you receive today. Your Beautician has given you all information of risks including, swelling, redness of skin, light bruising, soreness. If here for RF cavitation or skin tightening. You understand that staying hydrated is crucial to massage or cavitation & lack of H2o can & will result in a slower healing time and results will vary with weight loss management. This is a Medical device and you agree that you have knowledge of all certifications needed to perform your natural healing or weight loss procedure.
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