BOOK COSMETIC SERVICE

COSMETIC SERVICES

Appointment Request Form & Deposit

* Indicates required field

NAME (FIRST & LAST) *

EMAIL *

PHONE *

DATE OF BIRTH EX MM/DD/YYYY *

SKIN TYPE (SELECT ONE) *

UPLOAD PHOTO OF YOUR FACE WITHOUT MAKE UP *

Max file size: 20MB

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

Max file size: 20MB

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? *

Wait a few moments for confirmation after clicking Submit.
It takes a moment for the server to load HD images.

If booking Cosmetic Tattoo, clicking Submit will redirect you back to Scheduling Page.
If booking Anti-Aging Treatment, this can be ignored as you will be contacted by Rosalie directly.

Thank you!!!

Submit

COSMETIC SERVICES

​Appointment Request Form & Deposit

Appointment Request Form & Deposit