New Client Appointment Request Form
Completing the appointment request form will assist me in finding the most suitable days and times for your schedule.
Client Information:
I am currently pausing new client bookings in Southern California due to limited studio availability. If you would like to be added to my waitlist, please complete the form below. I will contact you as soon as a studio space becomes available.
Which location are you interested in?
*
Please Select
CA, San Jose
WA, Seattle
Southern California (temporarily paused)
Have you had previous Permanent Makeup done (i.e. microblading, nano hairstrokes, microshading, ombre powder brows, or micropigmentation)?
*
Please Select
Yes
No
Client Legal Name
*
First Name
Last Name
Client Date of Birth
*
/
Month
/
Day
Year
Date
Client Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Client Email
*
example@example.com
Contact Person (the person whom helped you schedule or who I'll be in contact with your behalf)
First Name
Last Name
Contact Phone Number
Format: (000) 000-0000.
Contact Email
example@example.com
Which day is best for your appointment?
*
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Any day
How soon would you like to come in? For example: ASAP or beginning of June.
*
Client Medical Information:
Select the options that apply to you:
*
Pregnant
Breastfeeding
HIV +
Hepatitis
High Blood Pressure
Diabetic
Hemophilia or Bleeding Disorders
Heart Conditions
Cancer
Under Radiotherapy or Chemotherapy
Stroke or Epilepsy
Autoimmune Disorder
Cold Sore
None of the above
If applicable, list any other(s) known medical conditions:
Select the skin condition(s) that apply to you:
*
Keloid
Acne
Dermatitis
Eczema
Hyperpigmentation
Cancer
None of the above
If applicable, list any other(s) known skin conditions:
What's your skin type?
*
Please Select
Normal
Dry
Oily
Combination
Have you had Botox injection(s) to your forehead?
*
Please Select
Yes
No
If applicable, when? Please type in the date (MM/DD/YYYY format) from your last Botox injection(s) to your forehead.
COLORMAIWORLD STUDIO POLICY
No guests or pets allowed in the studio. Guests may wait in the waiting room or lobby area.
To reschedule, let us know at least 72 hours in advance. You can reschedule once, but if you need to reschedule again, a new fee is needed. If you don't reschedule but inform us 72 hours before your appointment, the fee will be valid for one year. You can contact us via text or email to request a rescheduling.
If you're over 20 minutes late, your appointment will be canceled, and you'll need to pay a new fee to reschedule.
If you don't show up for your appointment or cancel within 72 hours, you can only book another appointment after paying the full procedure fee.
We do not accept Credit/Debit Card, Check, PayPal, or CashApp. Booking fees can be arranged via Zelle. Payment for services must be made in cash at the time of your appointment.
All payments are non-refundable and cannot be transferred between clients.
Signature
Submit
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