New Client Form

Customer Details:
Full Name

First NameLast Name
Date of Birth

MonthDayYear
Date
Phone Number
Format: (000) 000-0000.
E-mail
example@example.com
Instagram @
How did you find Little Bee Beauty?
Have you had eyelash extensions/lash lift before? If so when?
Do you have any inspiration photos of the look you want to achieve?

Cancelof
Allergies and/or sensitivities (frequent eye irritation, watery eyes, and/or itchy eyes ect)?
Are you pregnant?
Recent history of chemotherapy?
Current use of contacts, eye medication or antibiotics? Have you had any eye surgery within the last 6 months?
By signing this form, I am acknowledging and understanding all information listed. This agreement will remain in effect for this procedure as well as all future follow ups conducted by the technician listed. I consent to this agreement and the eyelash extension application/removal procedure.
Signature
Date

MonthDayYear
Date
Should be Empty:

Customer Details: