Name *

First Name

Last Name

Which service are you interested in? *

Production Makeup

Special Occasion Makeup

Date *

MM

DD

YYYY

Time *

Hour

Minute

Second

AM PM

Name *

First Name

Last Name

Date of the Wedding *

MM

DD

YYYY

Time of the Ceremony *

Hour

Minute

Second

AM PM

Address of where the makeup services will be performed *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Name *

First Name

Last Name

Appointment Date

MM

DD

YYYY

Appointment Time

Hour

Minute

Second

AM PM

Check One

Eyebrows

Eyeliner

Lips

Cheeks

Do you have any body art tattoos?

Yes

No

Do you currently have any permanent cosmetic makeup tattoo?

Yes

No

Name *

First Name

Last Name

Click the option you prefer. *

One on One Session

Group Makeup Class

Date *

MM

DD

YYYY

Time *

Hour

Minute

Second

AM PM

Name *

First Name

Last Name

Nova Lash Extensions *

Full Set

Maintenance or Fill

Date *

MM

DD

YYYY

Time *

Hour

Minute

Second

AM PM

Name *

First Name

Last Name

Date *

MM

DD

YYYY

Time *

Hour

Minute

Second

AM PM

Have you had a lash lift before? *

Yes

No

If so, when was the date of your last lash lift?

MM

DD

YYYY

Name *

First Name

Last Name

Preferred Appointment Date

MM

DD

YYYY

Preferred Appointment Time

Hour

Minute

Second

AM PM

Inquiring About (Check all that apply)

Brow Mapping & Grooming

Brow Lamination

Brow Tint

Brow Henna

Lip Wax

If inquiring about waxing, do you have any allergies to hard or soft wax?

Yes

No