New Client Form for Nail Tech Fran

NEW CLIENT WAITLIST

Thank you for your interest in becoming a client! Please complete this form to be added to my waitlist. When appointment availability opens, I will personally reach out using the contact information provided.
Client's Name*

First NameLast Name
Phone No*
Email*
Date of birth*
DD-MM-YYYY
Builder/Soft Gel ManicureHard Gel ManicureGel X ExtensionsNatural Nail RehabOther (please specify in the Notes box at the end of page)
DiabetesSkin Condition (Eczema, allergies, ect.)Fungal InfectionNoneOther (please specify in the Notes box at the end of page)
YesNo
Are you currently using or applying products to your nails? If yes, please list the name of the products below*
When is the last time you had a professional nail service and what service did you receive ?*
SplitBittenGood
DryInflamedNormal
YesNo
Please list below your availability - include preferred days and times for your appointments *
By signing below, I confirmed that all information I entered in this form is accurate and true.

I agree for any photos taken during and after the treatment to be used for marketing purposes.

I understand that services may be denined if the provider believes my nail condition is not suited for certain services and agree to respect professional suggestions.
Client Signature*

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Date Signed*

MonthDayYear
Date
Should be Empty:

NEW CLIENT WAITLIST