Consultation Form

Basic Information
Today's Date*

MonthDayYear
Date
Name*
Samantha Estevez
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*

Area CodePhone Number
Birthday*

MonthDayYear
Date
Gender*

FemaleMalePrefer not to sayOther
How did you hear about Beauty.Works?*

Website/OnlineFacebookReferralOther
Please List who referred you:
Race/Ethnicity*

African American/African/CarribeanAsian/Pacific IslanderCaucasianHispanic/LatinoNative AmericanOtherPrefer not to answer
If you Chose Other, Please List:
Are you interested in Lash Extensions?

YesNoDon’t know enough about it, May be Interested
Have you received Lash Extensions before?

YesNoOther
Your Health
Do you have any allergies?*

Tree NutsAloeLatexGlutenAspirinShellfishIodineFragrances/Essential OilsOtherNone
If Other, Please List Below:
Are you Currently on medication?*

YesNo
If Yes, Please Specify:
Are you pregnant or think you might be?*

YesNoMaybe
Are you undergoing any Hormone Replacement Therapy?*

YesNo
If there is any additional information you feel is necessary to disclose, please write it below:
Cancellation/Rescheduling Policy
- NOTE: All Independant Artists will have their own version of Policies on their link, tailored to their services If they are not under Beauty Works LLC directly. Please make sure to read upon booking.
- All cancellations must be made via Telephone, Booking site, or Email.
- If you must cancel or reschedule an appointment, please do so at least 48 HOURS before your appointment. All cancellations must be made and confirmed via online or telephone.
- If you cancel an appointment within 48 hours of your appointment time, Your card on file will be charged 50% of the total amount scheduled. You are allowed one warning if mentioned to us.
- If you RESCHEDULE an appointment within the 48 hour mark, you will be charged 30% of your appointment.
- No Call/No Show will be charged 50% of the appointment cost to the card on file. After your first no call/no show, a deposit will be required for future appointments booked of 50%. After your 2nd no call/no show, you will be banned from booking another appointment.
- A working card will be required at time of booking your first appointment to cover any future cancellation fees if necessary. If your card is not active, you will need to communicate that to us and switch to a new one on file.
- If your card fails to charge for any fees, you have 24 hours to communicate and cover before you can book. If your card fails and we do not hear from you within 24 hours, you are no longer allowed to book an appointment. Please make sure you are following these policies to avoid losing booking privileges!
- Rescheduling will be limited to 3 times for an appointment. Unfortunately after the third time you have rescheduled the same appointment, you will no longer be allowed to reschedule. We rely on you and your appointment and will have to give the spot to another client.
- There is a 10 minute grace period when arriving to your scheduled appointment. If you show up later than 10 minutes, you will have to reschedule and will be charged 30% of that appointment cost. If you do not reschedule at that time you will be charged a No Call/No Show fee of 50% of the appointment cost. If you do not reschedule at the time of your appointment you will be charged a No Call/No Show fee of 50% of the appointment cost.
- There will be no refunds. If there is an issue regarding your service, we will offer a free touch up within 24 hours. If you fail to reach out within the 24 hour period, you will no longer receive a touch up without a paid appointment.
  If a reaction should arise due to services, we will provide an emergency removal for Lash Extensions. There will be no refunds, as the artist has spent time and product to complete your service.
- There is a 12 hour window for booking. We cannot promise an appointment slot if it is not booked 12 hours or earlier.
I have read and acknowledged the Cancellation/Rescheduling Policy and agree to the terms.
Liability Policy
- I understand that it is imperitive that I disclose all of my information requested in the Client Information/Health form.
- I understand if I am unhappy with the services provided, the esthetician is under no obligation to issue a refund unless the esthetician deems it necessary.
- I consent "Before And After" photographs for the purpose of documentation, potential advertising, and promotional purposes.
- I have cited all conditions/circumstances regarding my current Health/Health history including medications and recent procedures.
- I understand that these services may be offered with the acceptance of the Esthetician in training. Pricing will be discounted (If Disclosed) until the esthetician decides to change it based on experience and skill.
- I will consult with Beauty Works NH immediately about any changes, questions, or concerns regarding the services that were provided.
- I do not hold my esthetician responsible for any of my conditions that were present, but not disclosed at the time of procedure, which may be affected by the services performed.
- I give my esthetician permission to provide any beauty services I have discussed, and will hold him/her harmless and nameless from any liability that may result in the treatment.
- I agree to follow all after-care instructions and understand that if I do not follow instructions my esthetician has the right to decline future services and will not be held liable.
- I understand my esthetician will take every precaution to minimize or eliminate negative reactions as much as possible.
I have read and acknowledged the Liability Policy. I agree to the terms and conditions listed above.
Pre-Appointment Guidelines:

We ask you come with a clean face and no makeup for any service done on the face, eyes or eyebrows.

No product around the area for atleast 24 hours.

Please Review Pre Appointment Guidlines on our website.
Parent/Guardian or Client Signature
By providing my signature, I certify that I fully understand and agree to all terms. *

Clear
Should be Empty:

Basic Information

Your Health

Parent/Guardian or Client Signature