Pre- Service Form

First Name

Last Name

Phone

Message ( Is there somethign you dont like when getting your Nails done?)

Have you had an Nail Infection?

Yes

No

Have you ever had an Allergic Reaction?

Yes

No

Diabetes?

Yes

No

Do you have any skin conditions such as psoriasis or aczema?

Yes

No

Do you have a history on picking or biting at your nails or cuticle?

Yes

No

Any know allergies to products / Latex/Plasters/Resin?

Yes

No

Thanks for submitting!

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