Booking Form
Please provide your personal information below. Thank you!
Today's Date
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AM/PM Option
First Name
*
Please type first name.
Last Name
*
Please type last name.
D.O.B. (MM/DD/YYYY)
*
Mobile Phone
*
Email Address
*
example@example.com
Occupation
Esthetics Information
What type of skin do you have?
*
Normal
Oily
Dry
Combination
Have you ever had an allergic reaction to any of the following?
Cosmetics
Medicine
Topical Anasthetics
Food
Animals
Sunscreen
Drugs
Pollen
AHAs
Fragrance
Latex
Do you currently or have you used in the last 3 months Retin-A, Renova, AHA's, or Retinol/Vitamin A derivative products?
*
YES
NO
If yes, please describe...
Have you received Botox, Restylane, or Collagen injections in the last 6 months?
*
YES
NO
Date
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Month
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Year
Date
If yes, please specify...
Date
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Time
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AM/PM Option
Appointment Type
Consultation $100
Powder Brows (no previous work) $550
Touch up #1 (within 8-weeks of initial procedure only) $250
Touch up #2 (6 months-1 year) $325
Touch up #3 (over 1 year) $450
Touch up #4 (over 2 years) $550
Updated Policy:
Cash, Credit Cards, PayPal and Venmo (@wasan-najar) accepted.
The non refundable booking fee is required at the time of booking to set your appointment. This fee will be credited towards your service.
Must pay another booking fee if rescheduling within 1-week of appointment date. You will loose the 1st booking fee and it will not be credited to your service.
If you choose to cancel, no show, or show up more than 15 minutes late to your appointment at any time the booking fee is forfeited.
Venmo payments: Please make payments to "@wasan-najar."
PLEASE DO NOT BOOK OR COME TO THE APPOINTMENT IF YOU MAY HAVE BEEN EXPOSED TO COVID/COLD OR HAVE ANY SYMPTOMS WITHIN THE LAST 14 DAYS. RESCHEDULING FEES WILL APPLY.
Client Signature
*
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Booking Fee For New Clients
This booking fee is a non refundable fee to set your appointment. This fee will be credited towards your service. You must give at least 1 month notice for rescheduling or another booking fee will be needed to change your date and the 1st deposit will not be credited towards your service. Any no shows, cancellations, and late shows will loose the booking fee. *If you have previous work done your powder brows service fee is $550. Your balance on the day of service will be $250.
$
100.00
Booking Fee For Returning Clients
Non refundable booking fee to set your appointment. This fee will be credited towards your service. If you need to reschedule you must give at least 1 month notice or another booking fee will be applied to change your date and the 1st deposit will not be credited towards your service.
$
100.00
Consultation
Non refundable booking fee to set your appointment. This fee will be credited towards your service. If you need to reschedule you must give at least 1 month notice or another booking fee will be applied to change your date and the 1st booking fee will not be credited towards your service.
$
100.00
Payment Methods
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First Name
Last Name
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Card Expiration
Security Code
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