Brow Lamination/ Lash Lift Consultation

Lash Lift Consultation

If you are receiving a lash lift please fill out this form as accurately as possible
Name

First NameLast Name
Please check all that apply to you:
Have you had recent microblading or cosmetic tattooing services?
If yes, please specify what and when:
Check all skin products/ medications you use:
Have you had Brow/ lash tinting, lash perming, lash extensions, or brow henna done previously?
If yes, did you ever have any adverse reactions to the treatment?
If yes, specify the reaction:
Agreement: I request and consent to these procedures being carried out without undergoing a sensitivity patch test. The sensitivity test, which if conducted, may indicate my sensitivity/ allergy to the products. I understand the contents of this form and take full responsibility for my actions, thus absolving all other parties of their responsibilities, if any, associated with the supply of the products and services.
Signature
Date

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Date
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