Client Information
Name
First Name
Last Name
Birthday
-
Month
-
Day
Year
Date
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Email
example@example.com
Instagram Handle
How did you hear about us?
If referred, please specify
Nail History
How would you describe your nail health?
Strong
Normal
Weak
Peeling
Brittle
Other
What products have you used in the past?
Gel
Builder Gel
Acrylic
Gelx
Other
Have you ever had a nail infection?
Please Select
Yes
No
Have you ever had an allergic reaction?
Please Select
Yes
No
Do you take any medication?
Please Select
Yes
No
Are you pregnant?
Please Select
Yes
No
Do you smoke?
Please Select
Yes
No
Do you do a lot of work around your home?
Please Select
Yes
No
Do you use hand lotion?
Please Select
Yes
No
Do you have any skin conditions pertaining to your hands or feet (psoriasis or eczema)?
Please Select
Yes
No
Do you have any broken skin?
Please Select
Yes
No
Do you do any hands on hobbies or sports?
Please Select
Yes
No
Do you have any history of picking or biting at your nails or cuticles?
Please Select
Yes
No
Do you have any medical or skin conditions? If yes please specify:
Preferences
What shape do you prefer?
Almond
Coffin
Stiletto
Square
Duck
Other
What length do you prefer?
Extra Short
Short
Medium
Long
Extra Long
Preferred Colors/Style?
Consent & Agreement
I confirm that the information provided is accurate to the best of my knowledge. I understand that all services are non refundable. I agree to follow after care instructions for best results.
Signature
Submit
Submit
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