Lash Lift

Lash Lift
PERSONAL DETAILS:
Name

First NameLast Name
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Address
Date of Birth

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Date
Phone Number
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Email
example@example.com
PREVIOUS DISCOMFORT, STINGING OR ADVERSE REACTIONS: Please click any that apply:
Allergies to acetone
Any medications
Other relevant information
Have you had Lash or brow tinting, Lash Lifting, Lash perming, Eyelash extension or semi-permanent mascara applied previously?
AGREEMENT: I request and consent to these procedures being carried out today 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(s
Signature
Date

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Date
BEAUTY PROFESSIONALS NOTES
Treatments being performed
Should be Empty: