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Donna Beauty
Consultation Form

Donna Beauty Facial Consultation Form

I would like to receive information about the goods and services which may be provided by DONNA BEAUTY, including (but not limited to) offers, promotions and information about new goods and services, via the following channel:

我希望收到有关 DONNA BEAUTY 可提供的商品和服务的信息,包括(但不限于)优惠、促销和有关新商品和服务的信息,通过以下方式:

I would like to be contacted via:
What brought you to us today? 是什么让您今天来到我们这儿?
What are your main concerns? 您想改善什么?
Concern for the eyes? 眼部改善?

Health Questionnaire 健康查询表

The following information is required to ensure your well-being during your visit at DONNA BEAUTY. All particulars and information collected will be kept confidential and used for the purpose of completing sales transaction only.

以确保您在 DONNA BEAUTY有更良好的治疗,以下的信息是必须的。所收集的信息将被保密并仅用于完成销售交易。

Select one (1) or more of the following conditions:

For Female only 只适用于女性

Are you currently pregnant or have given birth recently? 您是否怀孕或刚生孕?

I hereby declare that all the information which I have provided above are correct to the best of my knowledge and I have not withheld any relevant information.


Thanks for submitting!

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