top of page

 Hollywood Nail Spa Intake Form

 Hollywood Nail Spa Intake Form

Personal Information

Medical Information

Are you taking any medications?
No
Yes
Are you currently pregnant?
No
Yes
Do you suffer from chronic pain?
No
Yes
Have you had any orthopedic injuries?
No
Yes
Please indicate any of the following that apply to you.

Information

Have you had professional nail services done before?
No
Yes
Do you currently have any existing enhancements/polish on your nails that need removal?
None / Bare nails
Regular Polish
Gel Polish / Shellac
Acrylics / Dip Powder
Hard Gel / Builder Gel (BIAB)
What type of service are you looking for today?
Regular Manicure / Pedicure
Gel Manicure / Pedicure
Dip Powder (SNS)
Acrylic Full Set / Refill
Gel Extensions / Builder Gel (BIAB)
Nail Art / Custom Design
Spa Foot Care / Callus Treatment
Do you have any skin or nail allergies / sensitivities? (e.g., UV gel, acrylics, acetone, lotions, fragrances, latex)
No
Yes
Do you have diabetes or poor blood circulation? (Important for foot care & cuticle work)
No
Yes
Drawing mode selected. Drawing requires a mouse or touchpad. For keyboard accessibility, select Type or Upload.
Drawing mode selected. Drawing requires a mouse or touchpad. For keyboard accessibility, select Type or Upload.
logo
bottom of page