Name *

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Birthday *

MM

DD

YYYY

Cancellation Policy *

In the event you wish to cancel your appointment, you may do so online at jessicawilson.glossgenius.com. If we are unable to cancel your order, this means the 24-hour cancelation policy as outlined during your initial booking has passed. It is no longer possible to make changes or cancel the appointment without a rebooking fee of $25 per service booked. No shows will also be required to pay the rebooking fee and may lose the option of online booking in the future.

Yes, I agree

No, I do not agree and will not proceed with services today