Contact Us  

 

 

All of our locations provide our Laser Hair Removal service. Many of our locations offer a combination of our services of Electrolysis, Skin Rejuvenation, Skin Tightening, Broken Capillaries, Microdermabrasion, & Chemical Peels.

Please fill out the "Are You a Candidate?" questionnaire below. This form will help us evaluate your situation and get back to you with our recommendations.

(* fields are required)

  First Name*:
  Last Name*:
  Email* To ensure delivery, add info@permanentchoice.com to your address book:
  Phone* (If at all possible, please include your phone number. Often our emails are mistaken for spam and we cannot verify if you received our information if you do not provide a phone number.):
  Best Time of day to contact you:
  Our Location closet to you:
  Service(s) of Interest*: (please choose all that apply)
  Laser Hair Removal | Electrolysis | Sun Damage (Photo Rejuvenation) | Skin Tightening
  Microdermabrasion and/or Chemical Peels| Profractional | Broken Capillaries | Other
  If interested in our hair removal treatments. How are you currently treating the excess hair? *
  Shaving | Waxing | Tweezing | Bleaching | Creams | Other
  What Area(s) are you concerned or interested in having treatments performed (please choose all that apply)? *
  Legs | Underarms | Face | Bikini | Back | Chest | Other
  Are you tan in these areas? Yes | No
  Your skin type*:  
 

Fitzpatrick Skin Types I-VI

Always burns, never tans.

Extremely fair skin, blonde hair, blue/green eyes.

Always burns, sometimes tans.

Fair skin, sandy to brown hair, green/brown eyes.

Sometimes burns, always tans.

Medium skin, brown hair, brown eyes.

Rarely burns, always tans.

Olive skin, brown/black hair and eyes.

Moderately pigmented.

Dark brown skin, black hair and eyes.

Black skin.

Black skin, black eyes.

     
  Color of the Hair You Want Removed*:

Red | Gray | Light/Blonde | Brown | Black

  Hair Type*: Coarse | Fine
  Your age*:
     
  Additional Comments: (please put additional comments below)
 
   
   
 


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