c o s m e t i c i n t e r e s t q u e s t i o n n a i r e
Post on 23-Mar-2022
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COSMETIC INTEREST QUESTIONNAIRE
150 Lakeview Circle Covington, La 70433 985-892-3376
NAME:_______________________________________________ DATE___________________
EMAIL ADDRESS:_______________________________________ PHONE #________________
Would you like to receive emails regarding cosmetic services and specials? Y N
Please check all that are of interest or concern to you
Please circle any of the following that you would like more information on:
Hydrafacial Microdermabrasion Chemical peelHair Loss SkinCare Products Unwanted Hair
Skin Tightening Make Up Dermaplaning
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