Contact
* indicates required field
Company * :
Contact
person * :
Address
line one * :
Address
line two:
City * :
Zip * :
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-- State --
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Phone:
Fax:
Email * :
Website:
Boutiques
Who
are you?
-- Who are you? --
Employee
Manager
Owner
Type
of boutique?
-- Type of boutique? --
Art gallery
Clothes boutique
Concept store
Skin care store
Other
Do
you currently sell products?
If
yes, what brand(s)?
Spas
Who
are you?
-- Who are you? --
Body therapist
Esthetician
Manager
Owner
Technician
Is
there a medical doctor on staff?
#
of facial rooms?
#
of body rooms?
#
of licensed estheticians on staff?
#
of body therapists on staff?
What
types of treatments does
Est.
volume in retail sales last year?
Est.
volume in services last year?
Other
skin care brands used, if any?
Medical
facilities
Who
are you?
-- Who are you? --
Manager
MD
Owner
Medical
specialty?
Do
you currently sell products?
If
yes, what brand(s)?
Do
you use lasers in your practice?
If
yes, what type?
#
of medical doctors on staff?
#
of licensed estheticians on staff?
