MANICURE AND PEDICURE CONSULTATION FORM

ALCHEMY SALON AND SPA
MANICURE AND PEDICURE CONSULTATION FORM
Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Format: (000) 000-0000.
Date of birth
Email Address
example@example.com
How did you hear about us?
Known Allergies
Medications
NAIL CARE HISTORY
Do you participate in any activities/exercise/sports where you mainly use your feet?
How do you take care of your hands/ feet and toenails?
What products do you use on / apply to your nails?
Do you have any cuts or wounds on your feet?
What is the current condition of your toenails? Split, Ridged?
What is the current condition of your cuticles?
Additional Comments/Notes
NAIL TREATMENT DESIRED
Express manicureExpress pedicureSpa manicureSpa pedicureNail PolishAdd on gel polishAdd on glitter toesacrylicfrench styleadd on nail artadd on hotstoneadd on paraffin wax
No Slander Agreement
The client agrees not to in any way slander or injure the business reputation or goodwill of the Company Alchemy Salon and Spa or the Company's Affiliates through any contact with customers, vendors, suppliers, employees or agents of the Company or Company's Affiliates, or in any other way.
Signature

Clear
Model Photo Release Form - Alchemy Salon and Spa
I hereby give permission to Korbie McNeil DeGrey to use my photographic likeness in all forms and media for advertising, exposition displays, trade, teaching material and any other lawful purposes
Signature

Clear
Date

MonthDayYear
Date
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No Slander Agreement