Let’s work together Name * First Name Last Name Email * Phone (###) ### #### What services are you interested in? Permanent Makeup: Brows Permanent Makeup: Lips Permanent Makeup: Eyeliner Body Tattoo Which Artist Cassie Madelyn Carrissa Preferred Date MM DD YYYY Medical Questionnaire * Please check if any apply to you currently or within the last 30 days. Any additional medication or medical concerns please list in the message. Pregnant or Breastfeeding Under Dermatology care Chemo or Radiation within 6 months Surgery Botox within 14 days Blood thinner Cholesterol Medication Message * Thank you!
