The Beautology Shop Client Form
Please fill out this form to help us understand your needs. Note: The Beautology Shop & employees are not responsible for any reactions from treatments or services. By submitting, you agree to future notifications and acknowledge applicable payment fees. We Obtain The Right to Refuse Service.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Select Treatment or Service
*
Please Select
Facial
Body Sculpting
Intimate Bleaching
Waxing
Are you currently pregnant?
Yes
No
Date of Last Menstrual Cycle
-
Month
-
Day
Year
Date
Are you currently using Retinol or Accutane?
Are you taking any medications? Please list them.
Additional Notes or Allergies (if any)
Consent and Acknowledgment
*
I understand that The Beautology Shop & employees are not responsible for any reactions from any treatments or services. This consent is for all treatments and services provided by The Beautology Shop and associates.
I agree to receive future email and text notifications.
I acknowledge that payments made via Zelle, CashApp, or other methods may incur additional fees.
I consent paying via any Digital Currency such as Zelle cashapp Venmo PayPal & etc… to The Beautology Shop.
Signature
Submit
Should be Empty: