Name
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First Name
Last Name
Email
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Phone
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(###)
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How did you hear about us?
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Instagram
Facebook
Google
Yelp
Referral
Other
What services are you interested in?
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Are you interested in booking a consultation prior to booking your service?
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Yes, a virtual consultation (FaceTime or Zoom)
Yes, an in-person consultation
Yes, an in-person demo consultation
No, I'd like to move forward with booking the service
What days of the week work best for you? (select all that apply)
What times works best for you? (select all that apply)
What are your brow goals? (select all that apply)
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What are your lip goals? (select all that apply)
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If "yes", how long ago and what service was done?
Skin Type (select all that apply)
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Additional Info or Questions
Appointment Request
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Anyone with any of the following at the time of the appointment CANNOT be accepted for permanent cosmetics:
Younger than 18 years of age
Using Accutane or have used Accutane within 1 year from appointment date
Freshly tanned/sunburned skin
Pregnant/Nursing
Viral infections (cold/flu/etc.) or disease
If I have diabetes, cancer, heart condition or am currently undergoing treatment for cancer, or on immunosuppressants, I will provide my doctor's approval. I understand that my results may be affected by these conditions.
I have you read over the FAQ page on the Wild Violet website in its entirety.
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If not, please do so before submitting this form. If you have any questions, please email info@wildvioletcha.com
I have you read over the pricing page on the Wild Violet website in its entirety and understand the price of the service(s) I am requesting.
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If not, please do so before submitting this form. If you have any questions, please email info@wildvioletcha.com
Please add info@wildvioletcha.com to your address book so your consultation results don't go to spam or promotions. This is a very important step in getting your results
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By completing this form, I am submitting a digital consultation request and service inquiry. In response, I will receive an email with recommended service options. Your appointment in studio will begin with a full consultation to refine the plan for service. Generally, new guests are able to be seen within 2-3 weeks of digital consultation, but guests with limited availability may have to wait up to 6 weeks to be seen. I understand that we have a strict 48 hour cancellation policy and if I do cancel my appointment with less than 48 hours notice I will be subject to a 50% cancellation fee and I may be not be allowed booking future appointments with the studio. By clicking the submit button below, I agree to these terms.
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