Permanent Choice Contact & Lead Form

We’re So Excited to Meet You!

Let’s Get to Know Each Other!

Name

Phone number

Bloomington

What service(s) are you interested in?

Laser Hair Removal

Electrolysis

BBL-Photorejuvenation

What area(s) would you like to have treated?

(Choose all that apply)

Face

Underarms

Bikini/ Brazilian

Legs

Back/Chest

Other

What is the color of the hair you want treated?

Red

Gray

Light/Blonde

Brown/ Black

Please select

Anything else you'd like us to know?

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