NAME:
SERVICES REQUESTED:
REQUESTED DATE:
REQUESTED TIME:
PREFERRED PROVIDER: (IF APPLICABLE)
FOR HAIR REMOVAL SERVICES IS WAX, SUGAR OR LASER PREFERRED?
DO YOU HAVE HAIR EXTENSIONS?
FOR MASSAGE: (LENGTH OF MASSAGE 50, 80 OR 100 MINUTES)
TYPE OF MASSAGE:
QUESTIONS OR COMMENTS:
CERTIFICATE OR PRE-PAID VOUCHER NUMBER AND TYPE OF VOUCHER (IF ANY) (REQUIRED AT TIME OF BOOKING):
WOULD YOU PREFER A SILENT APPOINTMENT TODAY?
Please Select
Yes
No
WOULD YOU LIKE TO INCLUDE A COMPLIMENTARY SKIN CONSULTATION WITH YOUR SERVICES?
Please Select
Yes
No
WOULD YOU LIKE TO KNOW MORE ABOUT OUR MEMBERSHIPS?
Please Select
Yes
No
WOULD YOU LIKE TO INCLUDE AND HAIR WASH & STYLE AFTER YOUR SERVICES?
Please Select
Yes
No
WOULD YOU LIKE TO INCLUDE A JADE POD VISIT TO YOUR SERVICES?
Please Select
Yes
No
PHONE:
EMAIL:
DATE OF BIRTH:
-
Day
-
Month
Year
PREFERRED METHOD OF CONTACT (TEXT, EMAIL OR PHONE):
GENDER PREFERENCE: (IF ANY)
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