Skip to content
Home
About
Services
Women
Men
Pictures
Contact Us
Menu
Home
About
Services
Women
Men
Pictures
Contact Us
Book
Book
Home
About
Services
Women
Men
Pictures
Contact Us
Menu
Home
About
Services
Women
Men
Pictures
Contact Us
Client Safety
Fill out only once. Not every appointment.
Please enable JavaScript in your browser to complete this form.
Name
*
First
Last
Email
*
Phone
Address
*
Address Line 1
City
State / Province / Region
Postal Code
--- Select country ---
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia (Plurinational State of)
Bonaire, Saint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Congo (Democratic Republic of the)
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini (Kingdom of)
Ethiopia
Falkland Islands (Malvinas)
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran (Islamic Republic of)
Iraq
Ireland (Republic of)
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea (Democratic People's Republic of)
Korea (Republic of)
Kosovo
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia (Federated States of)
Moldova (Republic of)
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia (Republic of)
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine (State of)
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin (French part)
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten (Dutch part)
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syrian Arab Republic
Taiwan, Republic of China
Tajikistan
Tanzania (United Republic of)
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
Türkiye
Uganda
Ukraine
United Arab Emirates
United Kingdom of Great Britain and Northern Ireland
United States Minor Outlying Islands
United States of America
Uruguay
Uzbekistan
Vanuatu
Vatican City State
Venezuela (Bolivarian Republic of)
Vietnam
Virgin Islands (British)
Virgin Islands (U.S.)
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Country
Are you 16 years old?
*
Yes
No
Consent Form Required
*
I agree to submit a waiver. We do not serve minors without parental consent.
View Form
Date of Birth
*
MM
1
2
3
4
5
6
7
8
9
10
11
12
DD
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
YYYY
2026
2025
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
Gender
*
Male
Female
Other
Would you like to be informed about our latest offers by email?
*
Yes
No
Do you give us permission for your photos to be taken and used on our website and social media?
*
Yes
No
Choose all services you have had in the past?
*
Waxing
Laser
Eyebrow Lamination
Microdermabrasion
Chemical Peel
Laser Resurfacing
This is my first treatment
How long have you been using laser hair removal for?
*
Less than 6 months
Less than a year
1-2 years
More than 2 years
You had any reactions during or after your past services?
*
Yes
No
Please explain in detail
*
Are you allergic or have any skin conditions including?
*
Psoriasis
Eczema
Conjunctivitis
Dry Eye Syndrome
Eye Infection
Trichotillomania
Alopecia
No
Yes, Other
Please explain in detail
*
Select options that apply to you?
*
Cortisone
Hormone
Antidepressant
Contraceptive
Menopause
Diabetes
Allergies
Tobacco/Drugs
Stress
Cancer
Under Physician's care
Diabetes
Heart Problems
Thyroid
Hepatitis
Contact Lenses
None
Please explain in detail
Are you Pregnant?
*
Yes
No
If yes, cold laser treatment will not be performed on you.
Are you diagnosed with Epilepsy?
*
Yes
No
If yes, cold laser treatment will not be performed on you.
Do you have a Pacemaker?
*
Yes
No
If yes, cold laser treatment will not be performed on you.
Are you on any medication that may affect the sensitivity of your skin?
*
Yes
No
Please explain in detail
*
Do you take any medications?
*
Yes
No
List all medications
*
Terms
*
I agree with Shalu's Salon Terms and Conditions.
View Terms
Signature
*
Clear Signature
Signature Date
*
Submit
Starting May 1: Some service prices will increase, but most will stay the same!
Starting May 1: Some service prices will increase, but most will stay the same!
