New Client Screening Form Please submit REAL & HONEST answers. For my safety, I do my due diligence to screen all new clients. New Client Screening FormName (as it appears on your Driver License)Age & RacePersonal cell number that is registered in your nameHobby cell numberBoard HandlesAppointment Date & Time RequestAppointment LengthAppointment CityWhere did you hear about me?Employer Company NameEmployer Company WebsiteYour OccupationEmployer's Main Contact NumberYour Work Phone NumberYour Work Email Provide 2 active social media handlesBy selecting "I AGREE" you are acknowledging that you have read, understand, agree and will adhere to my policies regarding privacy and cancellation fees in ANY event that you have to cancel more than 12 hours after I have confirmed our meeting time.- Select -I AGREESubmit