Change your attitude. Change your wardrobe. Change your life.

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To help us learn more, please fill out the brief questionnaire below.
We'll contact you in 24-48 hours to schedule a private phone consultation.
 
 
1. Describe your current image in one short paragraph.
   
   
2. Why are you considering an image makeover?
(Select all that apply)		  
 

a. Want to look more professional
b. Want to save time getting dressed
c. Body has changed
d. Entering a new phase of life
e. Current image is outdated
f. Other (Please Explain):

 
   
3. What is your approximate age?
(Select one)		  
 



 
   
4. On a scale of 1 to 5, what number represents your level of image makeover anxiety?
(One being Least Anxious , 5 being Most Anxious). Circle your answer below:		  
 



 
   
5. Please fill in the blank:
  When I get dressed, I want to feel/look in my clothing.
     
 
Name: 
   
Email: 
   
Phone: 
   
Best time to be reached: 
   
 
 
 
     

 
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