Nail Survey Name * First Name Last Name Email or Phone Number * How did you hear about us? Facebook Instagram Google Friend Any allergies? Yes No Please list allergies (if any) Preferred appointment time ASAP Weekdays 9AM–Noon Weekends Noon–5PM Weekdays Noon–4PM Weekends 9AM–Noon Weekdays 4–9PM Services interested in Gel Dip Pedicures Acrylic How often do you get your nails done? 1–2 weeks 2–4 weeks Rarely ever 4–6 weeks Interested in nail art? Yes No Do you have concerns about your nails or skin? Yes No Please describe your concerns Have you had any surgeries to your hands or feet? Yes No If yes, please describe surgeries Are you diabetic? Yes No Radio Option 1 Option 2 Thank you!
