Appointment Request Form
This is a digital consultation form to determine if you are a candidate for the requested procedure. Upon assessing your suitability, you will be provided with the option to schedule either an in-person consultation or the actual treatment.
Full Name
*
First Name
Last Name
Contact Number
*
Please enter a valid phone number.
Email Address
*
example@example.com
Who/what social media platform were you referred by?
*
Phiacademy Craft Master Carla Goycochea services by referral only.
What PMU procedure are you interested in?
*
Please Select
Microblading
Powderbrows
Combo Brows (Microblading & Powderbrows)
Airbrows
Lipblush
PMU Brows - Not sure which treatment yet
PLEASE SUBMIT 3 CLEAR PHOTOS OF YOUR EYEBROWS/LIPS AS FOLLOWS: FRONTAL VIEW, LEFT SIDE AND RIGHT SIDE. ALL UNDER GOOD LIGHTING.
*
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Please describe your skin type:
*
Normal
Normal to oily
Oily
Combination (T-zone)
Normal to dry
Dry
Acneic
Sensitive
Please describe what you would like to enhance on your eyebrows/lips?
*
Are you willing to wear the treated area (eyebrows/lips) darker than desired result for about one week?
*
Please Select
Yes
No
Do you use Retinol?
*
Please Select
Yes
No
Do you use tanning beds often?
*
Please Select
Yes
No
Are you currently pregnant or nursing?
*
Please Select
Yes
No
Do you understand that any PMU procedure requires at least two to three sessions to achieve desired results?
*
Please Select
Yes
No
Do you agree to following Craft Master Carla's recommendations on the amount of sessions needed to accomplish desired results based on skin type and color?
*
Please Select
Yes
No
Do you agree to providing images as requested so that Craft Master Carla can provide a digital design of the style that would suit you best?
*
Please Select
Yes
No
Do you agree to this establishment 's No-Refund policy as desired result is previously approved following digital design?
*
Please Select
Yes
No
Please disclose all medical conditions, if applicable.
*
I understand that it will take from 24-72 hours to receive a response and/or digital design of the service requested and I hereby certify that all the information provided above is true and accurate.
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