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You are Hair Free!!
Please fill out this form and we will send you a FREE GIFT!
Limit 1 per customer
See Terms & Conditions
Large Area-
FREE T-Shirt!
Small area=Small FREE GIFT
Clinic
*
Amarillo
Corpus Christi
El Paso
Lubbock
Midland
Staff Name
*
First Name
*
Last Name
*
Street Address
*
City
*
State
*
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Washington DC
Zip Code
*
Phone
*
Email Address
*
Gender
*
Male
Female
T Shirt Size
*
Small
Medium
Large
X-Large
I don't need one/Received one already
Hair Free Area(s)
*
🛈
+
-
What do you love most about being
Hair Free
*
I Feel Beautiful
More Confidence
Results - it works!
No more shaving/waxing
Little or no pain
Convenience
Affordability
Other
Tell us about your Hair Free Journey
*
Wish List
what other areas next?
*
Full Beard
Full Face
Bikini Brazilian extended
Bikini line extended
Full Back
Legs
Coolsculpting
Other
Other
Refer A Friend
Friend's Name
*
Friend's Phone
*
Marketing Consent
:
I give American Laser Med Spa permission to use the information provided on this form and the
photographs taken today for marketing purposes
*
Yes
No
Notes (if any)