• Extension Appointment Request Form 

    I am located in Roseville CA. Please fill in the information below for review. Expect email or text response within 1-3 business days. I appreciate your patience and look forward to meeting you!

     

  • Format: (000) 000-0000.
  • Your Birthday*
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  • How did you hear about me?*
  • What days work best for you? Check all that apply (the more flexibility you have the sooner I can accommodate)*
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  • Pick 3 days that can work for your schedule for your initial consultation.
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  • Date
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  • Date
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  • Have you worn Extensions before?
  • Do you allow your Stylist to use flash photography during your visit?

  • If a new guest, consult is necessary to ensure a successful service. It is a $50 consult fee to be paid in advance to book (Venmo, Zelle, or credit card). Once consultation is completed the fee will be put towards the extensions service chosen.

  • Cancellation Policies

     

    100% Full Payment is required for the following conditions: 

    • No Show: If you do not show up for an appointment, you will not be refunded your depoist. A new depoist is due before your next appointment.
    • Last-Minute Cancellation/Reschedule: Failure to cancel or reschedule your appointment at least 24-48 hours in advance will result in a charge of 50% of the scheduled appointment fee. Payment is due before your next appointment. 

     

  • Sickness Policy

    Please reschedule your appointment as soon as you are aware of an infectious or contagious condition. 

    If you arrive for your appointment with symptoms of an illness, you must reschedule your appointment. 

    If you experience any of the following symptoms, you must reschedule: 

    • Fever or Chills
    • Vomiting or Diarrhea 
    • Runny Nose 
    • Sore Throat or Cough
    • You are currently taking an antibiotic. 
    • You have a skin infection like ringworm or athletes foot. 
    • You or someone in your direct care has a cold, sinus infection, or flu bug.
    • You or someone in your direct care has been diagnosed with influenza (the flu).

    Even if you are cancelling your appointment within the 24-hour notice period, the cancellation fee may be waived; the onset of symptoms doesn't always have great timing, right?

  • Informed Consent

  • By typing my first name, last name, and providing my e-signature below, I am indicating the following: 

    1. I have read the New Client Intake Form for Jem Aesthetic, LLC in its entirety. 

    2. I fully understand all questions and information provided in the New Client Intake Form for Jem Aesthetic, LLC. 

    3. I have completed the New Client Intake Form for Jem Aesthetic, LLC accurately and to the best of my knowledge. 

    4. I have read and I understand the expectations and policies for Jem Aesthetic, LLC and I agree to the terms and conditions outlined.

  • Today's Date*
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