Client intake form
Name
First Name
Last Name
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Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
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Email
example@example.com
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All options must be checked off in order for your appointment to be approved. Thank you!
I understand all risks associated with this procedure (application/removal of eyelash extensions) and technician will not be held liable due to any damages that occur (eg. allergic reaction) to me or my lashes.
I consent to “before and after” photographs for the purpose of documentation, potential advertising and promotional purposes.
I understand this procedure and consent to receive services.
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Please indicate if you have any allergies to latex, lash tape, adhesives, synthetics, seasonal allergies, etc. If not applicable please type N/A.
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Should be Empty: