Permanent Choice Laser Hair Removal Centers - MN Laser Hair Removal and Minnesota Laser Hair Removal

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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* Please add info@permanentchoice.com to your email's address book:

Phone*:

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 & Chemical Peels | MicroLaser Peel | Profractional | Broken Capillaries

If interested in our hair removal treatments. How are you currently treating the excess hair? *

What Area(s) are you concerned or interested in having treatments performed (please choose all that apply)? *

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.
	Always burns, sometimes tans.	Fair skin & sandy to brown hair.
	Sometimes burns, always tans.	Medium skin & brown hair.
	Rarely burns, always tans.	Olive skin & brown/black hair.
	Moderately pigmented.	Dark brown skin & black hair.
	Black skin.	Black skin.

Eye Color:

Green | Blue | Brown | Black | Other

Hair Color in Areas of Treatment*:

Red | Gray | Light/Blonde | Brown | Black

Hair Type*:

Coarse | Fine

Your Age*:

Gender:

Female | Male | Transgender

Additional Comments:

(please put additional comments below)

You must specify an email address

Ten Minnesota Locations - Make your appointment today.

Apple Valley	Eden Prairie	Minneapolis	White Bear Lake
952-898-1111	952-898-1111	612-338-2811	651-407-9876
Bloomington	Mankato	Rochester	Woodbury
952-898-1111	507-345-6966	507-536-7931	651-730-0700
	Maple Grove	St. Cloud
	763-420-6606	320-229-7610

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