Injector Partnership Interest Form

Injector Partnership Interest Form

Crystal Ngozi Beauty & Esthetics
Thank you for your interest in partnering with Crystal Ngozi Beauty & Esthetics.

We are a results-driven skincare studio focused on helping women of color achieve clear, healthy skin through advanced treatments and education.

We are currently exploring injector partnerships to expand our service offerings in a way that aligns with our brand, client experience, and long-term growth vision.

This is a collaborative opportunity for experienced, professional injectors who are looking to grow within an established brand and client base.

Please complete the form below. Qualified candidates will be contacted for a follow-up conversation.

Please note: This opportunity is best suited for an injector who already has, or is prepared to obtain, their own liability insurance and cover any required MD/medical director fees.
BASIC INFO:
Full Name*
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Email*
example@example.com
Instagram Handle (if applicable)
City + State*
LICENSING & EXPERIENCE:
What is your current license?*

RNNPPAOther (please specify)
How many years of injectable experience do you have?*

Less than 1 year1–2 years3–5 years5+ years
Which services do you currently offer?*

Botox / DysportDermal FillersLip FillerPRP / PRFOther (fill in)
COMPLIANCE:
Do you currently have malpractice insurance? This role requires you to carry and maintain your own professional liability/malpractice insurance*

YesNoIn progress
Do you currently work under a Medical Director? This role requires you to have your own medical director (MD) and cover all associated oversight fees.*

YesNoOpen to securing one
BUSINESS & CLIENTELE:
Do you currently have an active client base?*

Yes (consistent clients)Some clients (still growing)No (just starting)
How do you currently attract clients?*
What are you looking for in a partnership?*

Treatment spaceClient growthBrand alignmentFlexible scheduleLong-term business growth
ALIGNMENT:
Why are you interested in partnering with Crystal Ngozi Beauty & Esthetics?*
How would you describe your approach to client care and natural results?*
What does a great client experience mean to you?*
PARTNERSHIP EXPECTATIONS:
This opportunity is structured as a 1099 independent contractor role with a revenue split. It is best suited for injectors who are comfortable operating independently rather than in a W-2 hourly position. Are you open to a revenue-split partnership model?*

YesNo
What are your availability preferences?*

WeekdaysEveningsWeekendsFlexible
Are you able to provide:*

Active licenseProof of malpractice insuranceMedical Director information (if applicable)
PORTFOLIO:

Please use this space to provide links and/or photos of your work.
Please provide a link to your work (Instagram, website, or portfolio)*
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Injector Partnership Interest Form

BASIC INFO:

LICENSING & EXPERIENCE:

COMPLIANCE:

BUSINESS & CLIENTELE:

ALIGNMENT:

PARTNERSHIP EXPECTATIONS:

PORTFOLIO: