session requests NAME*PHONE*Email*CALL TYPE*In-Call (you come to our location)Out-Call (we come to your location)HOW MANY PERSONS?*Please select12345Date*Time*TREATMENT*Please selectMassageFacialEyelash ExtensionsLash LiftSESSION LENGTH*30 Minutes60 Minutes90 MinutesMEDICAL HISTORYHeadachesVaricose veinsCancerDiabetesHeart circulation problemSprains, strainsMajor accidentArthritis, tendinitisAllergiesAbnormal skin conditionNeck/back injuresHigh/low blood pressureNumbnessBlood clotsTMJFibromyalgiaJoit surgeryRecent injuresADD SPECIAL NOTESSendThis field should be left blank
