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Coastal Moon Salon 

Client Intake Form


It is my sincerest hope to provide you with the best luxury beauty and wellness services you've ever received. I want you to be happy with every visit and I hope to build a long-lasting relationship with you. For me to service you to the best of my abilities and to help you be the healthiest YOU, please answer the questions below as completely and accurately as possible. 

Thank you!


Have you been hospitalized in the last 12 months?
Are you suffering from a medical condition, illness, or injury?
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