REVIVE + THRIVE EVENT Application

Once you’ve submitted your application, you will be contacted via email: [email protected]. Spots are limited but all applications are kept on file for future consideration.

Please follow the steps below to make sure you qualify for FREE Ultra Realistic Areola Tattoo & Medical Art Services. We look forward to speaking with you!

IN ORDER TO APPLY

1. Fill out this application below.

2. Follow our Social Media Pages on Instagram and Facebook @outlinerstudio.

3. Like our Revive + Thrive Social Media Post.

4. Share our Revive + Thrive Post in your stories/feed.

5. Fill out your Client Intake Forms. All spaces must be filled out in order to submit.

Full Name *

Date of birth *

Address

Street Address

City

State

Country

Postal Code

Have you read over all pre procedure, aftercare, and our policies? *

Yes, I have read, accept, and agree

No, I have not read this information provided by this website.

What describes your need for our Medical Art services best? (Select ALL that apply) *

I need bilateral Ultra Realistic Areola Tattoo

I need unilateral Ultra Realistic Areola Tattoo

I lost my brows due to breast cancer and chemotherapy and need PMU brow services

I need Scar Camouflage services due to breast cancer

Other

Are you currently under the care of a Physician in regards to any major medical issues? (Diabetes, heart disease, joint replacement, currently undergoing chemotherapy or radiation) *

I have none of the major medical issues listed above

I am currently being treated for one or more of the medical issues listed above

Have you had breast surgery within the past 6 months?* *

I have had breast surgery within the past 6 months

I am currently undergoing chemotherapy or radiation

It has been >6 months since my last surgery, and I am cleared by my surgeon to receive Ultra Realistic Areola Tattoo & Medical Art Services

Email *

Mobile Number (must be able to receive text messages) *

Please tell us a little bit about you!

I do realize that there are limited appointments available. Also, I understand that by submitting this application does not mean that my appointment is scheduled or accepted. Please understand that at booking, we will require a $50 deposit to hold your spot, and to make sure you are serious about scheduling this appointment. (No showing or last minute cancellation to this appointment will mean that someone else will not receive this free gift!) This deposit will only be refunded after you have shown to your appointment time or cancelled >48 hrs in advance.*