Let’s work together to make you feel like your best self

Permanent Makeup Request Form

Please fill out to the best of your knowledge & we will get back to you as soon as possible.

If you have any questions, please list them in the form, or contact us!

Please check out the Permanent Makeup Info page before scheduling an appointment!

Name

First Name

Last Name

Phone

(###)

###

####

What services are you interested in?

Eyebrows

Lip Blushing

Preferred Date

YYYY

Have you had any facial peels/laser facials in the past month?

You have to wait at least a month after these treatments to have a PMU service

Have you used Retin A or Hydrocortisone creams in the past month?

You will have to discontinue use 1 month before PMU procedures

Have you been on Accutane?

You will have to discontinue use 1 year before PMU procedures

Anything else?

Blood Thinners, Mitral Valve Prolapse, any long term medical conditions?

How did you hear about us?