Perfectly Pretty
Please complete prior to your appointment.  Your responses assist us in providing the best experience possible.
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Name *
Email *
Address *
Phone number *
What Services are you interested in? ( Please note if you are scheduling for Facial Wax Services, you must be Retinal free for one week) *
What is your goal? *
Have you had this or similar Services before?  Were there any issues or concerns? *
Do you have any allergies?  If so please explain *
Are you on any medications?  If so please list. *
Do you have any medical issues which may interfere with receiving Services?  If so please explain *
How did you hear of us?  If you were referred, please list name of referral so they receive credit. *
Is there anything that you would like us to know, concerns you may have, questions etc? *
Facial Services - Describe your skin and list what you currently use on your skin.  Please be detailed and honest
Facial Services - Do you enjoy steam, hot towels, massage?  Any areas you would like us to avoid?
Facial Services - Are you interested in product recommendations to help you achieve your skincare goals?
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This form was created inside of Perfectly Pretty by Sheila. Report Abuse