Consultation request form

Consultation request form - LIP BLUSH
Name

First NameLast Name
Email
example@example.com
Birth date

MonthDayYear
Date
Do you or have you ever had any of the following health or skin concerns - especially in the area being tattooed - that I should be aware of? (Check all that apply)
If other, please explain:
IMPORTANT: If you have ever had a cold sore or fever blister even once in your life you MUST take an anti-viral medication such as Valtrex for a few days prior to your appointment and for a few days after the procedure to prevent an outbreak (or as directed by your physician).
Have you ever had your lips previously tattooed?
What are you looking to achieve with this procedure?
Additional Questions:
Please submit clear photos of your bare lips (no makeup, no filters) as well as any lip color inspiration you may have. Photos should be taken in good lighting, preferably natural light, I recommend taking the photo facing a window during the day.

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Consultation request form - LIP BLUSH