BROW CORRECTION/COVERUP

BROW CORRECTION/COVERUP

Request Consult Form
FULL NAME*

First NameLast Name
EMAIL*
example@example.com
DATE OF BIRTH*

MonthDayYear
Date
ADDRESS*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
MOBILE*
Please enter a valid phone number.Format: (000) 000-0000.
ARE YOU CURRENTLY USING ANY MEDICATIONS?*
IF YES, PLEASE PROVIDE MORE INFORMATION BELOW.*
WHAT PROCEDURE DID YOU RECEIVE AND HOW LONG AGO DID YOU HAVE IT DONE?*
PLEASE TICK ANY OF THE FOLLOWING THAT MAY APPLY TO YOU.*
DO YOU HAVE OILY, DRY OR COMBINATION SKIN?*
PLEASE ATTACH A CLEAR IMAGE OF YOUR FULL FACE AND NO MAKE-UP. (THESE IMAGES MUST BE TAKEN WITH SUFFICIENT LIGHTING TO ASSESS THE BROWS CLEARLY)*

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ATTACH A CLEAR IMAGE OF YOUR DRIVERS LICENCE OR ID*

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DO YOU UNDERSTAND THAT NOT ALL COSMETIC TATTOOED BROWS ARE CORRECTABLE AND A CORRECTION/COVERUP IS BY APPROVAL ONLY*
DO YOU UNDERSTAND THAT YOU MAY REQUIRE A SESSION OF LASER TATTOO REMOVAL IF I FEEL YOU NEED TO LIGHTEN YOUR BROWS TO GET A BETTER OUTCOME FOR A CORRECTION/COVERUP.*
SELECT SERVICE ARE YOU WANTING?*
DO YOU AGREE THAT THE BOOKING FEE REQUIRED IS A NON REFUNDABLE, IF YOU DO WISH ANY CHANGES/CANCEL WITHIN THE 7 DAYS, UNFORTUNATELY YOU FORFIT YOUR BOOKING FEE. IF YOU NO SHOW THEN YOU FORFIT YOUR DEPOSIT AND 50% OF YOUR APPOINTMENT FEE.
DO YOU ALLOW CONSENT FOR PHOTOS/VIDEOS TO BE TAKEN DURING YOUR PROCEDURE FOR SOCIAL MEDIA (INSTAGRAM, FACEBOOK ETC)
ONCE YOU HAVE FILLED OUT ALL INFORMATION REQUIRED, CLICK "SUBMIT". ALL CONSULTATIONS MAY TAKE UP TO A WEEK FOR A RESPONSE. PLEASE MAKE SURE YOU CHECK YOUR JUNK FOLDER AS I WILL REPLY TO ALL CLIENTS WHO REQUEST A CORRECTION, WITH EITHER APPOVALS OR NEEDING LASER TO START FRESH.
YOUR SIGNATURE
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