TNCB Client Form (nails)

Client Form
Date

MonthDayYear
Date
Name

First NameLast Name
Email
example@example.com
Address

Street Address

Street Address Line 2

City Province

Postal Code
Phone Number

Area CodePhone Number
When was your last nail service?
Are you diabetic?
Are you pregnant?
Do you have allergies?
If you answered yes, please list your allergies:
Do you have any skin conditions or nail concerns?
If you answered yes, please list your skin conditions or nail concerns?
If you have any concerns with your hands and feet that we should know about before your appointment, please list your concerns.
Do you have any health conditions we should know about before proceeding with the service?
What polish colour do you have in mind for the services (pinks, reds etc.)?
How did you hear about us?
Were you referred by anyone?
Would you like to be added to our mailing list to receive special promos?
I (client) understand the nature of the services. I hereby discharge The Nail and Champagne Bar, its owner, and employees of and from all claims, demands, damages, actions, and cause of action arising out of the performance of services provided.
Signature

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