Pico Tattoo Removal Inquiry

Please submit this form if you are interested in a free tattoo removal treatment to help evaluate a new Pico laser.

Please note, we may only treat part of the tattoo or might treat part with the Revlite and part with the Pico.

**Results may vary patient to patient. There is no guarantee that any specific result can be achieved.

Last Name*
First Name*
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Email*
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Are you currently a patient?	YesNo
Reason for Appointment
Which SOMA Skin & Laser Location?	Millburn, NJParamus, NJ
Enter three appointment days/times that work for you. We will confirm by email.
Date Time
Date Time
Date Time
Our hours of operations are: MILLBURN: Monday 9:00AM-5:00PM Wednesday 9:00AM-5:00PM Thursday 9:00AM-6:00PM Friday 8:00AM-3:00PM
PARAMUS: Monday 1PM-5PM Tuesday 9:00AM-4PM and 12PM-6PM (alternate weeks) Wednesday 1PM-4:30PM Thursday 9:30AM-12PM
12+48=?