Name *

First Name

Last Name

What color is the majority of your unwanted hair? *

Black

Brown

Red

Blonde

Grey / White

Salt and Pepper

What is the cause of your unwanted hair? *

*This info helps me develop a treatment plan specifically for you

I don't know the cause

PCOS

Transgender

Menopause

Heredity

Other

Preferred Appointment Time(s) *

Weekday Business Hours (Mon-Fri, 10am-6pm)

Weekend (Saturday and Sunday)

Weekday Evening (Mon-Fri, 6pm or later)

Weekday Early Morning (Mon-Fri, before 10am)