Best Phone Number for Contact *

Preferred Method of Contact *

Top Desired Services

What is the top challenge you are having with your hands or feet? Do you currently have a care routine at home for in between professional services? *

What product is currently on your nails, if any? Do you use care products at home? What is your main nail concern?

To take extraordinary care of your nails and skin, I look at your overall health and lifestyle to determine the best care practices. Diabetics, expectant mothers or anyone with circulatory issues must make us aware of their conditions before pedicuring. I reserve the right to refuse service if I feel there may be a medical complication. This is for your safety! Only your nail technician has access to these forms, so please answer honestly. Mark any health conditions you are being treated for: *

I verify that all above information is correct. I agree to comply with all Covid and health safety measures deemed necessary by Lush Nail Lounge LLC to maintain safe conditions during nail services. I release Lush Nail Lounge LLC of any liability for failure to disclose health conditions or health changes before the scheduled service. Reservations require a credit card on file to hold that slot especially for you. Lush Nail Lounge does not have access to any card information. If you prefer to not give that information, I encourage you to call in the morning to see if we have walk in time slots for that day. If you don't turn up for your appointment or cancel at short notice, you will be charged a $25 no show fee. Please contact me at least 24 hours before your appointment if you need to reschedule. I do not apply gel enhancements or polish to anyone under the age of 16, NO CHILDREN OR PETS OR EXTRA FRIENDS MAY TAG ALONG AT YOUR APPOINTMENTS! Please verify and agree, and sign with your full name. *

Full Name E-Signature *

For our birthday club specials, please give me the month and day of your birthday.