Flawless Face and Body Clinic

NAME (REQUIRED)

EMAIL (REQUIRED)

CONTACT NO. (REQUIRED)

CHOICE OF TREATMENT/S

DATE OF APPOINTMENT (REQUIRED)

TIME OF APPOINTMENT (REQUIRED)

CLINIC LOCATION

MEDICAL INFORMATION (OPTIONAL)

ANY ADDITIONAL COMMENTS (OPTIONAL)

I verify that I am of legal age (18 years old and above) to undergo this treatment. I understand that booking my appointment using the Flawless App does not guarantee that the clinic can accommodate me for the treatment, especially if the doctor will not permit me for my safety.