Forever Dazzled Intake Form

Forever Dazzled Intake Form
Name*

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example@example.com
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Please enter a valid phone number.Format: (000) 000-0000.
Todays Date*

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Birth Date*

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BraceletAnkletNecklaceRingStacked 2Stacked 3Stacked 4GoldSilver
You are guaranteed to LOVE your forever jewelry! I guarantee my weld. If at any point the chain comes apart at the weld, I will reweld at no cost book an appointment with the "fix, tighten, reweld appointment option. If the chain breaks within 7 days of purchase, please also reach out for further instruction, any breaks after 7 days you'll need to purchase a new chain. I WILL COVER ONE CHAIN FIX AND ONE CHAIN TIGHTEN. After these are both used I will charge $7 each reweld or tighten unless you are purchasing another chain. If the current chain cannot be fixed, a new chain will need to be purchased. I will offer 10% discount.

Sales tax will be applied at payment*
All Sales are final* No Refunds***
I understand that if I have any concerns, I will address these with my technician. I give permission to my technician to perform the above activity we have discussed and will hold him/her/them and his/her/their staff harmless and nameless from any liability that may result from this activity. I understand my technician will take every precaution to minimize or eliminate negative reactions as much as possible. I agree that this constitutes full disclosure, and that it supersedes any previous verbal or written disclosures. I certify that I have read and fully understand the above paragraphs and that I have been provided sufficient opportunity for discussion and to have any questions answered. I understand the procedure and accept the risks. I do not hold the technician/owner responsible for any conditions of jewelry that were not present at the time of this activity/purchase that may take effect over time.
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