C O S M E T I C I N T E R E S T Q U E S T I O N N A I R E

Post on 23-Mar-2022

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COSMETIC INTEREST QUESTIONNAIRE

150 Lakeview Circle Covington, La 70433 985-892-3376

NAME:_______________________________________________ DATE___________________

EMAIL ADDRESS:_______________________________________ PHONE #________________

Would you like to receive emails regarding cosmetic services and specials? Y N

Please check all that are of interest or concern to you

Please circle any of the following that you would like more information on:

Hydrafacial Microdermabrasion Chemical peelHair Loss SkinCare Products Unwanted Hair

Skin Tightening Make Up Dermaplaning