Thank you for your interest in our services! Please fill out the form below, and we'll be in touch to discuss availability.
Name
First Name
Last Name
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Email
How did you hear about us?
Social Media
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Referral from Friend/Family
Referral from Medical Professional
Black Friday Offer
Referred By:
Please select the city closest to your location:
Jacksonville, FL
Orlando, FL
Atlanta, GA
Augusta, GA
What type of skin do you have?
Normal
Dry
Oily
Combination
Unsure
What services are you interested in?
Ombré Powder Brow (Makeup Airbrush Effect)
Eyeliner Enhancement (Subtle or bold definition along lash line)
Lip Blush/Neutralization
Skin Revision - For stretch marks or scars that are raised, indented, bumpy, or uneven, whether dark or light. This treatment smooths texture and improves appearance over time.
Skin Camouflage - For flat, light-colored stretch marks or scars. This treatment uses pigment to blend the area with your natural skin tone.
📸 Please upload clear photos of the area you’d like treated. (No filters. Good lighting. Area must be visible for proper evaluation.)
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For Restorative Tattoo Inquires
Please will out the questionaries below to provide better consultation services for your appointment.
What area(s) of your body are you hoping to treat?
Please be specific — e.g. lower tummy, hips, thighs, buttocks, breasts, back, arms, knees, or shoulders. You can also include C-section scars, tummy tuck scars, breast lift or augmentation scars, post-liposuction marks, or stretch marks from pregnancy, weight loss, or puberty.
How do your scars or stretch marks affect your confidence or comfort?
You can share how long you’ve had them, how they make you feel, or what you hope to change through this treatment. There’s no wrong answer — this helps me understand your goals and whether the treatment is a good fit.
Are your scars or stretch marks fully healed and over 12 months old?
Yes
No
Unsure
Have you had any prior treatments on this area?(e.g. laser therapy, microneedling, chemical peels, or anything intended to improve the skin’s appearance.)
Yes
No
If yes, please explain
Are you currently on blood thinners, Accutane, or Retin-A?
Yes
No
Do any of the following apply to you? (Check all that apply)
Keloid-prone skin
Autoimmune condition
Currently pregnant or breastfeeding
Bloodborne illness (HIV, Hepatitis)
Diabetes
None of the above
Please write any questions or concerns we should know about
How would you prefer to be contacted for scheduling and follow-up?
Text message
Phone
Email
I consent to the use of my documentation including photos, videos, healing updates, and testimonials for marketing, educational, and portfolio purposes. My face will never be shown publicly without my explicit permission.
I agree to the above terms
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