Appointment Submission Form
After you complete this appointment request, Rachel will contact you to go over details and availability before appointment is confirmed. If you would like direct information pricing and availability please contact Rachel at CosmoRayRay@gmail.com
Email address *
Your name *
Your answer
Phone number *
Your answer
Preferred contact method *
Required
Are you a new or existing customer?
Were you referred by anyone?
Time available
What is the service you are interested in? *
Required
Date of last service? Service received? *
Your answer
Any allergies? *
Your answer
Please list any medications and/or supplements that you are taking. *
Your answer
Are you pregnant? *
I release and hold CosmoRayRay (Rachel Brau), harmless against any and all liability, damage, and/or expenses arising out of or in connection with actions, claims, and/or damages resulting in personal injuries and disabilities (physical and/or psychological) that I might incur as a result of the chemical altercation to the nail during any nail service processes. I understand that additional treatments may be recommended and/or necessary for my nail maintenance and that permanent damage to my nails is possible due to the chemical application. By typing my name and today's date here, I agree to these terms. *
Your answer
Questions and comments
Your answer
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