Appointment Request Form

Appointment Request Form

Please fill out the following information for the waiting list. We will reach out to you when we are ready to take new clients.
Full Name*

First NameLast Name
Contact Number
Please enter a valid phone number.
Email Address*
example@example.com
By providing your cell phone number, you have provided us with consent to send you text messages in conjunction with the services you have requested. Your cellular provider’s message and data rates may apply to our confirmation message and all subsequent messages.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
What beauty services are you interested in?*

Eyelash Extentions (Natural Classic and Natural Volume Styles)Makeup 101 Lesson (Beginner-friendly!)Makeup Applications (Natural & Glam Makeup)Customized Your Own Foundation (Our customizable foundation builds from sheer to full coverage, letting you create your perfect look – from a natural tint to flawless tattoo coverage)Facials (Natural Firmness and Glow Facial with Circadia)
Feeling overwhelmed by beauty choices? Discuss your unique needs and goals, ask questions, and get personalized recommendations via text or a quick phone call.
Want to quench your thirst for beauty innovation while you wait on the waitlist?*
We're offering a free sample product to try at home! This exclusive product is designed to help the skin to look firmer and more supple while helping to reduce the appearance of fine lines and wrinkles with a novel skin care ingredient, Neodermyl®. Your feedback will help us shape the future of our beauty services. It's a win-win – you get to experience cutting-edge beauty for free, and we get valuable insights to make our services even better. Products are limited for the first 25 customers, so claim your free sample today!
Would you like to receive exclusive offers and discounts on our services and products?

YesNo
By answering "Yes", you agree to share your email address with the site owner and MailChimp to receive marketing, updates, and other emails from the site owner. Use the unsubscribe link in those emails to opt out at any time.
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