Client Consultation Form
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Full Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Birthday
*
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Month
-
Day
Year
Instagram
Example @The.Cosmic.Lash
How did you hear about The Cosmic Lash?
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Have you had your brows waxed with cold wax before?
*
Please Select
Yes
No
If so how was your experience?
Have you had your brows shaped with a tweezer before?
*
Please Select
Yes
No
If so how was your experience?
Have you had your brows tinted before?
*
Please Select
Yes
No
If so how was your experience?
Do you have sensitive skin?
*
Please Select
Yes
No
What is your skin type?
*
Please Select
Oily
Dry
Combination
Do you have any allergies to products/dyes?.
*
Please Select
Yes
No
*If you answered yes to this question please explain in the additional comment section at the bottom of the page before submitting this form!*
*please exfoliate 1-2 days prior to appointment, and DO NOT use self tanner or spray tan if you book a tint*
If you used spray tan/self tanner comment which one/when!
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‘I have read & agree to the terms of cancellation’
*
Please Select
Yes
The cancellation policy is in the image above as well as on my website (Cosmic-lash.square.site)
‘I read & agree to follow the appointment policies’
*
Please Select
Yes
Appointment policies are in the image above as well as on my website (Cosmic-lash.square.site)
‘I agree & consent to Francesca Amodeo preforming Brow services and do not hold my tech liable for any medical or physical occurrence!’
*
Please Select
Yes
*Non liability*
‘I give consent for pictures’
*
Please Select
Yes
No
If you don’t want to be posted just let me know in the comment section!
‘I give consent to the services (Brow Waxing/Brow Shaping/Brow Tinting) being done by Francesca Amodeo’
*
Please Select
Yes
If you are under the age of 16 you must have a parent text/call me to give consent! (631)652-5948
EVERYONE MUST SIGN THIS SECTION *with you’re real signature* unless you are 17 yrs old and younger, then you must have a parent read the policies and sign the form!
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Full printed name of the Parent/Guardian/Client signing & consenting
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First Name
Last Name
Date
*
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Month
-
Day
Year
Date
Additional Information/Comments
Submit
Should be Empty: