Cosmetic Tattoo Consult Form

First Name *

Last Name *

Date of birth *

Email *

Phone *

I consent to receive marketing text messages from Cinnamon Girl Clinic at the phone number provided. Frequency may vary. Message and data rates may apply. Text HELP for assistance, reply STOP to opt out.

I consent to receive non-marketing text messages from Cinnamon Girl Clinic about my appointment updates, appointment reminders, etc. Message and data rates may apply.

What best explains your situation? *

I've never had permanent makeup done and I want to become a Cinnamon Girl client

I've had permanent makeup done elsewhere but I want to become a Cinnamon Girl client

I'm an existing Cinnamon Girl client and I'm interested in more services

Other

If you selected 'other' please explain

Please attached relevant images below (ex. current brows needing correction OR tiny tattoo design inspiration, etc.)

Photo 1 Upload

Photo 2 Upload

Current Medication *

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