New Client Profile
Your privacy is very important. The following information is only used to stay in better contact with you.
Full Name
*
First
Last
Birthdate:
ex. 01/05/1960
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Mobile Phone Number
*
-
Area Code
Phone Number
Home Phone Number
*
-
Area Code
Phone Number
E-mail
*
ONLY used for updated information and appointment info.
What is the best way to contact you?
*
Phone call
Email
Text
All
How did you hear about me?
Google
Facebook
Instagram
Friend Referal
Town Link
Other
If your answer in the last question was REFERAL please give the name.
To cancel an appointment, please let me know at least 24 hours prior to your appointment. This allows me to have the ability to fill in the spot with another client needing an appointment.
*
I understand the cancellation policy.
I understand, life gets crazy, and things happen. However, if I have not herd from you within 15 minutes after your scheduled time it will be considered a No Show and you will be charged 50% of the full scheduled service price. This fee is due prior to rescheduling any other appointment.
*
I understand the No Show policy.
Date
*
-
Month
-
Day
Year
Date Picker Icon
Signature
*
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