Fantastic Nailz - Client Consultation & Profile
 -
We would like to know a little about you before you visit with us. This information will be kept confidential at all times. This information will be used for the sole purpose of providing you with the best services to fit your needs. (You may submit this form online or print the form and bring it with you to your first visit.)
 
Today's Date
Name
Address ( For special cards, events and mailouts)
City
State
Zip
Email (To keep you informed of our latest specials.)
Phone# (The best phone number to contact you.)
Birthday(Month,Day)
Do you have, or have you had, a history of:
Diabetes
Heart Disease
Thyroid Problems
Circulatory or Muscular Disease
Hypertension
Cancer
Allergies
Other (If you chose other, please explain below.)
Other
Are you currently taking any medication, whether prescribed or over-the-counter?
No
Yes
If Yes, Please explain:
Is your skin type:
Dry
Oily
Normal
Combination
Do you have a history of picking or biting at your nails or cuticles?
Always
Sometimes
Rarely
Never
Have you ever had an allergic reaction to any type of nail enhancement or other nail related products?
No
Yes
If Yes, Please explain:
Have you ever experienced a nail infection of any sort? (Nails or Toes)
No
Yes
If Yes, Please explain:
What are your favorite polish colors?
What is the best day for your appointment?
Tuesday
Wednesday
Thursday
Friday
Saturday
What is the best time for your appointment?
Morning
Noon
Evening
Do you plan to keep regular appointments to maintain your nails?
No, This appointment is for a special event.
No, I just want to try this one time.
Yes, I will keep regular appointments.
Yes, And I am interested in standing appointments.
Who referred you?, or How did you hear about us?
Fantastic Nailz reserves the right to charge for appointments canceled or broken without 24 hour notice. We do not like No Show, No Call appointments. Please give us a call within 24hrs of your appointment, if you do not plan to attend. Due to the potentially hazardous chemicals in the salon, please make other arrangements for your child(ren) on appoinment days, unless you child(ren) is being serviced. Fantastic Nailz will not be held accountable for injury or accidents to, or caused by, unsupervised children.
No, I disagree.
Yes, I Understand and agree.