Eyelash extensions form+Tint

Patch test has to be booked upfront 24/48 hrs and no waivers accepted !!! Every new client or returning client after 6 months required a patch test

First name

Last name

Mobile phone number

SMS subscribe

Multi-line address

Country/Region

Address

City

Zip / Postal code

Please leave instructions for parking. I am caring heavy equipment and FREE immediate parking is required

Birthday

Month

Day

Year

Please remove contact lenses prior to your treatment

Have you had eyelash extensions before

Yes

if Yes, elaborate more

Pregnancy

Yes

if Yes, elaborate more

Allergies

Yes

if Yes, elaborate more

Any eye problems in the past few weeks

Yes

if Yes, elaborate more

LVL, perm or tint on your lashes

Yes

if Yes, elaborate more

Do you use any eye make up or eye drops

Yes

if Yes, elaborate more

Please upload medical notes from your doctor, if you answer Yes to question above or upload proof of payment for parking

Upload your file

Choose a file or drag and drop one here.

I agree to terms and conditions and that information given in this forms is true

I agree to inform immediately, if my body temperature getting higher than 37C, develop a cough or loose my sense of taste and smell in the last 24 hrs prior to the treatment

Signature

Drawing mode selected. Drawing requires a mouse or touchpad. For keyboard accessibility, select Type or Upload.

Date

Month

Day

Year

Eyelash extensions form+Tint

Patch test has to be booked upfront 24/48 hrs and no waivers accepted !!! Every new client or returning client after 6 months required a patch test

Multi-line address

Country/Region

Address

City

Zip / Postal code

Please leave instructions for parking. I am caring heavy equipment and FREE immediate parking is required

Birthday

Month

Day

Year

Please remove contact lenses prior to your treatment

Have you had eyelash extensions before

Yes

if Yes, elaborate more

Any eye problems in the past few weeks

Yes

if Yes, elaborate more

LVL, perm or tint on your lashes

Yes

if Yes, elaborate more

Do you use any eye make up or eye drops

Yes

if Yes, elaborate more

Please upload medical notes from your doctor, if you answer Yes to question above or upload proof of payment for parking

Upload your file

Choose a file or drag and drop one here.

I agree to terms and conditions and that information given in this forms is true

I agree to inform immediately, if my body temperature getting higher than 37C, develop a cough or loose my sense of taste and smell in the last 24 hrs prior to the treatment

Signature

Drawing mode selected. Drawing requires a mouse or touchpad. For keyboard accessibility, select Type or Upload.