Name *

First Name

Last Name

What services are you interested in?

Massage

Facials

Waxing

Tattoo Removal

Teeth Whitening

Other

Do you have any skin sensitivities or medical conditions we should be aware of? *

Yes

No

Any recent surgeries or injuries we should know about? *

Yes - please describe below

No

Are you pregnant or breastfeeding?

Yes

No

Do you have any contraindications or health concerns? *

Examples: high blood pressure, heart condition, varicose veins, contagious skin conditions, etc.

Yes - Please describe below

No

Do you prefer a quiet environment or artist interation?

Quiet

I prefer chatting

Cancellation Policy Agreement *

I understand that we have a strict 24-hour cancellation policy and if I do cancel my appointment with less than 24-hour notice, I will be charged a $50 cancellation fee that must be paid before my next service.