Consult & Consent

Name

First NameLast Name

Name*

First NameLast Name

BIRTHDAY *

Date

Phone Number*

Please enter a valid phone number.Format: (000) 000-0000.

Email*

example@example.com

TextEmailPhone call

How did you hear about LK Studio?
Instagram Referral

YesNo

If yes please list.

YesNoIm not sure

YesNo

If yes please list.

YesNo

If yes please list.

YesNo

If yes please list.

YesNo

If yes please list.

YesNo

If yes please explain.

YesNo

Please list all the face products you use in a day. (Make up, cleansers, toners, creams, serums, oils etc.)*

DryOilyCombination

If you currently have extensions. How often do you wash them?

YesNo

BackSideStomach

What do you do for work?*

Iblanks* Agree to have eyelash extensions applied to my natural lashes and/or removed and retouched. By signing this agreement, I consent to the placement and/or removal of eyelash extensions by Lash kings Studio. I understand that in rare occasions there are risks associated with having artificial eyelash extensions applied to or removed from my natural lashes. I further understand that in rare cases as a part of the procedure, irritation and discomfort could occur. I agree that if I experience any irritation or discomfort with my lashes, that I will contact Lash King Studio and it may be beneficial to have the eyelash extensions removed.

Date

Signature*