Name *

First Name

Last Name

Date of Birth *

MM

DD

YYYY

Phone *

(###)

###

####

Which treatments do you wish to have? *

Ombre Brows

Powder Brows

Lip Blush

Eyeliner Tattoo

Desired result *

Natural

Defined

Bold/Full makeup look

Not sure

Do you wear makeup daily? *

Yes - Full Face

Yes - Minimal

Sometimes - When I can be bothered

No - Keep it natural

Skin Fitzpatrick *

Never burns, always tarns dark

Rarely burns, tans dark easily

Burns minimally, tans easily

Tans after initial burn

Burns easily, tans poorly

Always burns, does not tan

Please tick your skin type *

Very Dry

Dry

Normal

Combination

Oily

Very Oily

Preferred contact method

Phone call

Text message

Email

I understand that failing to fill out this form truthfully and correctly may result in my appointment not being able to be completed.

Yes