New Client Form

Full Name*

First NameLast Name

Date of Birth*

Date

Phone Number*

E-mail

example@example.com

Instagram @

How did you find Little Bee Beauty?

I consent to the application, removal, and/or retouching of eyelash extensions to my natural eyelashes by the certified technician I have booked in withI understand there are risks associated with the application/removal of eyelash extensions. Including, but not limited to: eye irritation and/or discomfortI understand and consent to having my eyes closed throughout the treatmentI understand that the look I am wanting to achieve may not be healthy for my natural lashes and may have to purchase a lash growth serum to achieve the look graduallyI agree to the policy/aftercare instructions given by the technician and realise that failure to follow these instructions may result in damage to my natural lashes, and/or decrease the life of my extensionsI consent to having my before and after pictures taken for advertising and marketing purposesI understand that I must have at least 50% of lash extensions left for a refill

Have you had eyelash extensions/lash lift before? If so when?

Do you have any inspiration photos of the look you want to achieve?

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

Customer Details: