New Client Consultation Form

New Client Consultation Form

Thank you so much for considering Kelly Marie Beauty, LLC for all your skin care goals. Please complete the items below so I can get to know you and provide the best experience possible.
Full Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Format: (000) 000-0000.
E-mail
example@example.com
Birthday:
How did you hear about KMB?
Referred by:
What Services are you interested in?
Have you had a facial before? What did you love/not love about your experience?
Brief description of your skin:
Have you ever had a chemical peel?
If you answered yes, how did your skin react?
Have you ever been waxed?
If yes, how did your skin react?
Are you taking any medication?
This will help me to determine how your skin may react to certain products and protocols.
If you answered yes, what medications are you taking?
Please list any allergies you may have. If none, please just type "none".
I, Name* agree to give 48 hours notice of any appointment cancellations and/or changes to the appointment reserved. I understand that routine no shows, altered or last minute cancellations may result in a 50-100% charge of the service total at my next appointment. A deposit of 50% on future appointments may be required, as well as a credit card on file, if this policy is not adhered to. (I completely understand that life happens and illnesses and/or emergencies come up unexpectedly. However, routine missed or altered appointments may signal that we are not a good fit for each other).

I understand the Kelly Marie Beauty is not liable for any adverse reactions, including but not limited to allergic reactions and breakouts.

I also understand that KMB is an independent business. Any offers from a third party such as Mist Beauty and Wellness will not be honored by Kelly Marie Beauty LLC. This includes Groupons, discounts, etc.

Thank you so much for choosing Kelly Marie Beauty for all your skin care goals. Please sign below to indicate that you understand the cancellation and no show policies. I look forward to working with you!
Signature*
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