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COSMETIC SERVICES

Appointment Request

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NAME (FIRST & LAST) *

EMAIL *

PHONE *

DATE OF BIRTH EX MM/DD/YYYY *

SKIN TYPE (SELECT ONE) *

UPLOAD PHOTO OF YOUR FACE WITHOUT MAKE UP *

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UPLOAD PHOTO OF YOUR FACE WITH MAKEUP (EYEBROW CLIENTS ONLY) *

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WHAT DAYS AND TIMES WORK FOR YOU? *

DEPOSIT AMOUNT *

WE REQUIRE A $100 NON-REFUNDABLE DEPOSIT TO SETUP AND HOLD AN APPOINTMENT. THE DEPOSIT COMES OFF THE TOTAL COST OF YOUR COSMETIC TATTOO. I AGREE THAT I AM DEPOSITING $100 TO SECURE A CONSULTATION APPOINTMENT. *

CARD NUMBER *

NAME ON CARD ( FIRST AND LAST ) *

EXP. DATE EX. XX/XX *

CVV *

BILLING ZIP CODE *

WHAT SERVICE ARE YOU REQUESTING? *

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COSMETIC SERVICES

​Appointment Request

Appointment Request