Your Details

Providing us your details helps us to provide a better match for our special offers, models training sessions, and case studies and also enables us to contact you quickly so you do not miss an opportunity. Items marked with * are required. 

Email Address:*
First Name:*
Last Name:*
Phone:*
Address Line1:*
Address Line2:
City:*
State:*
Post Code:*
Country:*
Sex:*

Male

Female

D.O.B. dd/mm/yyyy
//
Your Most Recent Treatments
 
(required for Student Models List and Case Study List)

If you have had any of the treatments below in the past please insert the approximate date (dd/mm/yyyy) of the last treatment, if you have not had any of these treatments before just leave the date field blank.

Eyebrow Tattoo:
//
Eyeliner Tattoo:
//
Lip Tattoo:
//
Scalp Hair Follicle Simulation Tattoo:
//
Areola Tattoo:
//
MCA / CIT / Skin Needling:
Multitrepannic - Collagen Induction Therapy.
//
MESO-Vytal:
//
Other Medical Tattooing:
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Your Disposition
(required for Student Models List and Case Study List)

Which of these statements best describes you:

Pick the statement that is closest to your usual disposition, this helps us prepare for your appointment.

I am a extremely relaxed and easy going, I never get stressed and I never take pain killers.

I am a mostly relaxed and easy going, I rarely get stressed or take pain killers.

I am generally relaxed and easy going, but I do get stressed sometimes
(and or)

I occasionally take pain killers.

I am a bit highly strung and quite particular
(and or)

I often get stressed
(and or)

I frequently take pain killers.

I am a very highly strung and very particular
(and or)

I get stressed easily
(and or)
I take pain killers regularly.

Join Our Subscriber Lists          

Our Student Models List:
Which of these procedures are you Interested in having performed by one of our students for the nominal charge of $75/procedure?
NB. The charge for SHFST treatments is 25% of the regular cost.
Eyebrow Full Lip MCA
Eyeliner Areola MESO-Vytal
Lipline/Blend SHFST Other Medical
Our Special Offers List:
Would you like to be informed about special offers?

Discounts & Promotions

Our Case Studies List:
Are you interested in participating in a case study and receiving your procedure performed by Andrea at either a substantial discount or sometimes free of charge?

Photographic Case Study

Video Case Study

Consent:*
You agree that we may contact you regarding the above offers and agree to the terms of the offers.
You can change your preferences or unsubscribe whenever you wish.