Care 4 Program Request form — Operation Pretty Things

NOTE: This form is to be filled out by representatives from partnering agencies only. We cannot offer services to individuals who are not otherwise associated with a shelter, agency or organization.

Care 4 Program service request Form

We are honored to offer you these services! We acknowledge your time is valuable, and will utilize each moment to ensure you are on time to your next obligation.

To help us better serve you, please complete the form below to the best of your ability. If you are unsure of an answer, you may skip it and let us know in the box at the bottom of the form how we can help.

The following are the guidelines for each C4P appointment:

Each women will be given a scheduled UP TO ONE HOUR appointment with our licensed professionals. Please keep that in mind when choosing available services. NOTE: Most appointments take approximately 30 mins.
Arrival time is 8:00am, unless otherwise specified, to allow ample time for the appointment. Should there be a conflict or delay, please contact us so that we can adjust accordingly - by text 910.616.5433
Any skin tone/hair type/etc information provided prior to the appointment is greatly appreciated, so that we can offer the maximum of care. Your time is important to us! This info will help us create the most efficient and relaxing experience.
If you are unable to make it to the appointment, that’s Ok! Please let us know prior to the day of the appointment if possible.

PLEASE NOTE: Skin and hair sensitivities MUST be disclosed prior to the appointment, at which point services may require modification.

Date of service

YYYY

Name of organization

Contact Name

First Name

Last Name

Phone

(###)

###

####

Name of client

First Name

Last Name

Client Phone (Per advocate approval. Note: OPT will not contact the client directly, unless otherwise specified.)

(###)

###

####

Please select Care 4 Services (10-30 mins per service)

Skin - Makeup

Hair - Hot styling

Skin tone

Skin type

Hair length

Hair thickness

Care 4 Closet - select items you need

Top

Pants/Skirt

Shoes

Tops/Shirts/Jackets

Pants/Skirts

Shoes

**Please specify any additional needs you may have, and/or clarification to options where "other" was selected.

**Operation Pretty Things is dedicated to offering care services using the finest beauty/skin and hair care products available. Operation Pretty Things, and its affiliates/ stylists/aestheticians/etc, are not held liable for any adverse reactions associated with the services/products provided and/or used at time of scheduled appointments. Should there be an adverse reaction to products and/or services provided, please contact your health care provider for assistance.