Returning Client Form

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Are you a new or returning client?*

NewReturning
First Name*
Last Name*
Birth Date

MonthDayYear
Email*
example@example.com
Do any of the following apply to you? (check all that apply)*

Pregnant or NursingAutoimmune DisorderChemotherapyActive Infection or currently on AntibioticsHave an upcoming surgery within 4 weeksTaking blood thinning medicationDiabeticTaking Fish OilHave had a chemical peel, facial laser treatment, or microneedling done within 4 weeksHave taken Accutane in the past yearHad botox injections within 2 weeksNone of these apply to me
When was your last session with Corinne?*

MonthDayYear
Date
Which service did you get?*
What type of appointment would you like to book?*
Have you gotten your brows touched up by someone else since your last appointment with Corinne?*

YesNo
When was that?*

MonthDayYear
Date
Please briefly explain what you got done:*

0/100
Is your health history the same as your last visit?*

YesNo
If No, please describe what has changed with any new medications or diagnoses*

0/100
Please submit a photo of your right profile and have it be a close-up of your right eyebrow.*

Cancelof
Please submit a photo of your left profile and have it be a close-up of your left eyebrow.*

Cancelof
Please submit a forward facing photo of your entire face.*

Cancelof
Let me know anything else here!
Should be Empty:

To avoid technical glitches, we highly recommend completing this form on a computer browser. If you're on a smartphone or tablet, please make sure it's updated to the latest software. Thank you!