Headshot Appointment Request Form

Headshot Appointment Request Form

Applicable to Complete Care Offices (ONLY)
Your Information:

Your appointment time will take approx. 5-10 minutes for photography.
First Name* Last Name* Email* Cell Phone (text savvy)
Medford - Brooke GregoryEagle Point - Cece Carvajal
LMT (Licensed Massage Therapist) - You will need Black ScrubsChiropractor - You will need a Doctor's CoatProvider - You will need a Doctor's CoatHealth CoachAdministrationOther
This is an Appointment REQUEST form only, not an automatic scheduling tool.

I will respond within 72-hours (business days) to confirm or communicate scheduling date and time.

Once Scheduled, I will provide you with a Headshot Handout Guide (one-page PDF). It will include: Planning Tips, What to Wear & What to Expect.
Headshot appointment availability: WEDNESDAYS*
Alternative Dates or Times, if the above selection is not available? (not required)

MonthDayYear
Date
Hour MinutesAM/PM Option
Medford Complete Care OfficeEagle Point Complete Care OfficeEither Medford or Eagle Point OfficesOther
Questions, Concerns, and Comments (re: your headshot photography with me only; I am not an employee of Complete Care):
(First, Last + Email)
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Your Information: