CLIENT INFORMATION SHEET

Name:__________________________________________________Address:___________________________City__________________

State:_______Zip Code__________Phone___________Cell________

Email:___________________Birthdate________Sex:___/____

Do you have allergies?  if YES, please list_________________________

Anything else we should know about you to be able to provide you with excellent service?__________________________________________

Please review our policy page and sign below that you understand our policies, including 24 hour cancellation notice:    __________________________

Date Signed________