Electrologist Data Sheet

You can help greatly by supplying information about your TG-friendly electrologist!  It will be added to the Directory of TG-recommended electrologists.

Items in red are especially important information.

Thank you in advance for your help!

PLEASE COPY ALL OF THE QUESTIONS BELOW INTO YOUR EMAIL and send to host@tsroadmap.com

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1. Electrologist contact information   

Electrologist name(s)  
Company name
Address
City, State, Zip
Phone:
e-mail:
website:

2. Days open (put an X by applicable days)

Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
 

3. Hours __ to ___

By appointment only?

4. Electrologist treatment information   

Number of electrologists in office:

Treatment with two electrologists simultaneously available?   

Modality used (%)      

Thermolysis
Galvanic
Blend

Type of probes available:

disposable
non-disposable
insulated
non-insulated
straight
tapered
bulbous
gold-plated
multi-needle galvanic

Electrologist wears a mask.
Electrologist wears gloves.
                                             

5. How you chose your electrologist:

TG referral
Advertisement
Internet
Non-TG referral
Other: 

Was consultation  free?

Were hairs treated?

Were certification/training documents displayed.

6.  Please state your opinion about this electrologist:  

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PLEASE COPY ALL OF THE ABOVE INTO YOUR EMAIL.