Great Photos Start Here PHOTO SURVEY Basic InformationName First Last Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Cell Phone Number*Alternate Phone NumberEmail Address What type of photos would you like?*---HeadshotsMaternityNewbornFollow me (Birth - 2 Years)FamilySenior PortraitEngagement PhotosBridalWeddingHow many adults will be in the photoshoot, and what are their names?*How many children will be in the photoshoot, and what are their names and ages?I authorize myheartcreative to take photos of all persons listed above.* Yes No Availability Mornings Afternoons Evenings Weekends Please check all that apply.Desired Photoshoot Date Range Do you already have a location planned or booked? Yes No If you have a location, where is it? If we are scouting locations, do you prefer indoor or outdoor? Yes No Both Please list any specific locations you would like us to check out?Are there any specific shots you have in mind? Yes No Please share an inspiration image.Max. file size: 256 MB.Please share an inspiration image.Max. file size: 256 MB.Please share an inspiration image.Max. file size: 256 MB.Please check the words that describe your tastes in photos. Candid Formal Casual Black and White Color Fashion What look/feel are you wanting to convey? Dramatic Artistic Modern Rustic Playful Classic Please share a link to any Pinterest boards with examples of looks you like. Please share a link to any Pinterest boards with examples of looks you like. Please share a link to any Pinterest boards with examples of looks you like. Do you have a wardrobe style and colors chosen? Yes No Please describe your wardrobe and colors, if already chosenDo you have any props or special items you would like to incorporate? Yes No How did you hear about us? Questions/Commentsmyheartcreative has legal permission to use photographs of me and my family for any lawful purpose, including, but not limited to publicity, illustration, advertising, and web connection.* I agree EmailThis field is for validation purposes and should be left unchanged.