Family session questionnaire

SELF REFERRAL

Legacy of Luv Photography Session Request
IMPORTANT INFORMATION

- Requests are received during our regular business hours: Monday - Friday, 8:30 AM - 4:30 PM.

- Lens of Luv observes the following holidays: Memorial Day, 4th of July, Labor Day, Thanksgiving, and December 25th - January 1st. During these times, our communication lines will be closed.

- Our photographers are volunteers; therefore, we cannot guarantee availability for every request.

- Our services are always provided free of charge.

- Approximately 7-10 days after your photo session, a private online gallery will be prepared for you.
Family Session

Thank you for taking the time to fill out this form. Your answers will help me in making this the best possible experience for you and your family!
Patient Name*

First NameLast Name
E-mail*
Phone Number*

Area CodePhone Number
Diagnosis (Please specify the diagnosis)
Patient Gender: (Select one)

MaleFemailOther
Type of session*

Newborn sessionSenior sessionEngagement or Couple sessionFamily sessionMaternity sessionOther
Preferred Session Date and Time

MonthDayYearHourMinutesAM/PM Option
Preferred Days and Times for the Photo Session? (We photograph Monday-Sunday at a mutually agreeable time for the family and our photographer. Please list your preferences.*
Who will be present at the session? (Please list the names and ages of all participants.*
Additional Information for Lens of Luv and the Photographer. (Please provide any further information that may be helpful, such as the patient's condition, any medical equipment in use, or mobility contraints.*
Preferred Location for the Photo Session*

I'd like the photographer to give me suggestionsI'd like the photographer to chooseI have a preferred location (please give the address and a brief description below)Other
Types of locations you are interested in: (select all that apply)*

Nature ParksNature Tall grassRustic BuildingsUrban/CityOther
Do you tend to favor more traditional shots with everyone posed and looking at the camera, or more interactive/candid images?*
Of the following which are the most important images you would like captured during your session? (select all that apply)*

IndividualsWhole FamilySibling GroupOther
Would you like suggestions on what to wear?*

YesNo
Of the following which do you prefer?*

Color PhotosBlack and White PhotosMixture of BothMajority Color with a few Black and WhiteOther
If you have looked on Facebook or the website gallery, are there any specific images that you are particularly drawn to or would like to try in your session?
Is there any special look you would like to create for your session?
Is there anything else you would like to share or you think would be helpful for me to know before your session?
How did you hear about Lens of Luv, Inc?*

FacebookInternet SearchDisplay/AdvertisementFriend/RelativeIf you were referred, who can I thank? (please name in "Other")Other
Have you ever worked with a professional photographer?*

YesNo
Do you have any questions for me?
Who should we contact for the session?
Preferred Form of Communication for Scheduling? (Select all that apply)

TextEmailPhone CallOther
Address for Mailing Keepsakes/Gifts

address 1

Address 2

CityState / Province

Postal / Zip CodeCountry
Confidentiality Agreement

By submitting this form, I understand that I am releasing the above patient health and demographic information to Lens of Luv, Inc.

All information is kept confidential and within Lens of Luv, Inc.

- I understand
Do you agree to the above terms and conditions?*

YesNo (By choosing 'no', your form will not be submitted to apply for the session)
Please sign your full name.*
Signature
Date*

DayMonthYear
Thank you for trusting Lens of Luv to capture the strength and resilience of your journey. We look forward to providing you with a meaningful and heartfelt experience.
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SELF REFERRAL

Family Session