Consultation request form
Brows & Freckles
Name
*
First Name
Last Name
Email
*
example@example.com
Birth date
*
-
Month
-
Day
Year
Date
What is your skin type? (check all that apply)
*
Dry
Normal
Oily
What service are you looking to book? (check all that apply)
*
Nano Hairstrokes
Ombré Shading
Combination Brows
Microblading
Freckles
Not sure, but I’m open to suggestions.
Do you have any of the following health or skin concerns - especially in the area being tattooed - that I should be aware of? (check all that apply)
*
Acne
Eczema
Psoriasis
Moles/Birthmarks
Alopecia
Trichotillomania
Cancer
Chemotherapy
Other
If other, please explain:
BROW INQUIRIES ONLY - Have you previously had your eyebrows microbladed or tattooed?
*
Yes
No
N/A
FRECKLE INQUIRIES ONLY - Have you previously had freckles tattooed?
*
Yes
No
N/A
Please describe what makes you unhappy about your current brows/previous permanent makeup/freckle tattoo.
*
What goals would you like to achieve for your brows or freckles with this procedure?
*
Please submit clear photos of your current brows or freckle inspiration below. Include photos of your head turned slightly left, one slightly right, and one face on. Please also include a photo of yourself and how you typically fill in your brows with makeup.
*
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