AESTHETIC MODEL SEARCH
417 Refine Academy is seeking models for upcoming trainings. If you are interested in being added to our waitlist, please fill out the form below. You will be contacted by text message and appointments are processed on a first come, first serve basis.
Model Name
*
First Name
Last Name
Model Date of Birth
*
-
Month
-
Day
Year
Date
Model Email
*
example@example.com
Model Phone Number
*
Please enter a valid phone number.
Are you in the 417 Refine system as a client?
*
Yes
No
Not sure
What discounted services are you interested in? (please select all that apply):
*
Neurotoxin ($7/unit)
Dermal Filler (1/2 syringe $250)
Sclerotherapy for spider veins ($75)
PCDC (fat dissolving areas like Kybella $250)
HydraFacial ($100)
Micro-needling with Exosomes or PRP ($250)
Chemical Peels: Vi Peel or BioRePeel ($150)
Biostimulator: Sculptra / Hyper Dilute Radiesse ($350/syringe)
Contact for other services
Do you have any additional questions or comments?
Consent
*
By participating as a model for 417 Refine Academy, I hereby grant permission to 417 Refine and its affiliates to use photographs, videos, or any other form of media taken during my treatment(s) for the purposes of marketing, social media, training, and educational content. I waive any rights and I certify that I am of legal age, have read and understood this consent, and voluntarily agree to its terms.
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