Model Inquiry Form

Model Inquiry Form

To be considered for model opportunities at Kyle Farr Aesthetics, please complete the following form. As models, you would have the unique opportunity to help educate other aesthetic practitioners. It's important to note that all models must provide consent to be filmed and photographed for educational and marketing purposes.
Name

First NameLast Name
Email
example@example.com
Cell Phone Number (for texting)
Please enter a valid phone number.Format: (000) 000-0000.
8-Point Lift (liquid facelift)Tox treatment (Jeuveau, Dysport, Botox, Daxxify, etc)Single area(s) dermal fillers (lips, cheeks, chin)Biostimulator Injections (Sculptra, Radiesse+)Silhouette Instalift (PDO Threadlift)Other
YesNo
YesNo
When was the last time you had an aesthetic treatment? If never put N/A.
Returns when pulled (tight)Slightly saggy (loose during movement)Moderately saggy (loose at rest)Very saggy (very loose at rest)
This virtual model consult is not a guarantee of a treatment plan/quote; and changes may need to occur when you are seen in person with Kyle Farr, DNP, NP-C. The virtual consultation does not establish a provider-patient relationship and we disclaim any liability with the material presented. The information presented should not take the place of personalized medical advise. The information in the virtual consult is not meant to treat, diagnose or serve as medical advise for any condition. It is solely meant to educate the consumer. Discussion of specific aesthetic, medical and wellness treatment is only done during an individual consultation with a provider.
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