Appointment Request Form | BROWS BY JENNY

First Name

Last Name

DOB

Month

Day

Year

Phone Number

Please enter a valid phone number.

Email Address

What service are you booking? (Select one)

Ombre Powder Brows - $700

Lip Blush - $600

Both, Brows and Lip - $1300

If you’ve had previous work done, an additional $100 correction fee will apply.

Have you had permanent makeup before on your brows or lips?

No, this is my first time

Yes, Brows

Yes, Lip

Both, Brows and Lip

If yes, upload clear photos of your previous work for approval.

Photos must be makeup-free, unfiltered, and taken in natural lighting. Please include front and side angles.

Preferred Appointment Date

Please select the dates you’re available for your appointment.

What is your main goal for this appointment?

Do you have any of the following? (Select all that apply)

Please list any medications or supplements you are currently taking

Have you received Botox, filler, chemical peels, or laser treatments in the last 4 weeks?

Yes

No

If yes, please describe

How would you like to pay?

Pay in full

Financing through Klarna, Afterpay and Affirm.

$200 non refundable deposit now, and the remaining due on the day of your appointment.

A $200 non-refundable deposit or full payment can be sent via Zelle to TangNCo.PMU@gmail.com. Please send a screenshot of the payment to (469) 899-0789 once it has been sent. We will schedule you in after confirmation.

I confirm that all information provided in this form is accurate and truthful to the best of my knowledge. I understand that withholding or falsifying information may affect the outcome of my procedure and I accept full responsibility for any consequences resulting from inaccurate information.