CLIENT INTAKE FORM
EYELASH EXTENSIONS
Name
B Day
Address
City
State/Zip
Instagram
How did you hear about me?
Is this the first time you have had lash extensions?
Y
N
If No, Why did you have them removed?
What products do you currently or have recently used on your lashes?
Mascara
Curler
Lash Serum
Lash Lift/Tint
Do you wear contact lenses? (If yes, please remove them before your appointment. Fumes can be trapped behind contacts and cause irritation)
Y
N
Do you have frequent eye irritation, itching or watery eyes?
Y
N
How do you sleep at night?
Back
Stomach
L Side
R Side
Please list any medications/antibiotics including supplements that you are currently using:
Do you have any of the following conditions? (Please check all that apply)
Allergies to Adhesive or Synthetics
Pregnancy
Sensitives to adhesive/tape/gel
Dry Eyes
Thyroid Disease
Eating Disorder
Diabetes
Cancer
Extreme stress or Hormonal Imbalance
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Booking Policy: I require a valid card to be kept on file. This card is not charged unless my cancellation policy is broken. I strongly suggest pre-booking your fill appointments before leaving to ensure you get the day/time needed so that you avoid any additional fees for lash loss/retention.
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Fill Policy: I ensure during your full set that lashes are applied correctly and sustainably. If you arrive to your appointment with 40% or less of your lashes remaining, I will do what I can in the appointment time you have booked. Please know this will not get you back to 100% coverage and you will need to book a follow up appointment within 7 days to get you back to full! Or a full set may be required if waiting until your next regular fill. Please reach out to me at least 72 hours before your appointment if you notice you need a longer fill time and I will do my best to extend your already scheduled time to avoid having to come back!
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New Client Fill Policy: If you are a new to me client, or you have seen another lash tech in between your appointments with me, you will be required to book the foreign fill option. I can not guarantee my work when working over others work as I do not know what products they use and how they may react with each other. If you come in with lashes that are unsafe for your natural lashes, I will require a removal and new full set. Your lash health is the most important!
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Late Policy: If you are running late to your appointment, I will do my best to fill in as many lashes as time allows. You will still be charged the full appointment price. And I suggest scheduling your next fill appointment sooner than normal, to get you back to 100% fullness. Remember the 40% fill policy still applies!
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Cancellation Policy: I understand "life" happens and you may need to cancel or reschedule an appointment. I ask that you give me 24 hours notice so I can adjust my schedule to accommodate other clients. In the event that 24 hours notice is not given, your card will be charged 50% of the appointment price.
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No Show Policy: In the event that you do not show up to an appointment, your card on file will be charged 100% of the appointment price.
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Children Policy: Please message me and let me know if you need to bring your child with you to your appointment. As a single mom myself, I understand! But please know your own child, if they are unable to sit still or entertain themselves I reserve the right to cancel/reschedule your appointment if your child is too much of a distraction for myself or you and you will be charged for the full appointment. Your eyes do need to remain closed during the appointment to avoid injury from fumes or glue.
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Makeup Policy: Please thoroughly remove all makeup before your lash appointment. Eyes must be clean and oil free upon arrival otherwise, I will charge a $10 makeup removal fee and the time spent thoroughly cleaning your lashes will be deducted from your fill time and you will still pay the full price. I am unable to adhere semi-permanent lash exertions on lashes that have makeup/residue buildup and in more severe cases, it can lead to irritation or infection. If I need to remove makeup, it will void my guarantee.
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Age Policy: Clients must be at least 16 years or older to receive services. Minors under 18 must be accompanied by a parent or guardian. Parent/Guardian must be present during the consultation process.
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Cell Phone Policy: I ask that you silence your cell phone during your lash appointment to remove distraction and the urge to open your eyes to check your phone. I am using sharp tweezers, glue and other products near the delicate eye area. Opening your eyes can cause injury or irritation.
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Refund Policy: Due to the nature of services, there are no refunds given on services rendered. You are paying for my time and product, which can not be refunded. If you have any issues with your extensions, please contact me immediately and I will do everything I can to make it right.
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Retention Policy: If you experience any premature shedding, please contact me immediately with pictures. If I am unable to make a proper assessment through the photos I may ask you to come in so I can assess in person. If I find that there was an error on my part during the application, I will re-do your lashes at no charge within 72 hours of your initial appointment.
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Allergy Policy: Allergic reactions can happen on any client, at any time; even on clients that have had lashes for years. Because I still used my time, product and there was no way for me to prevent a reaction, there will not be refunds given. I will be more than happy to provide you with a free removal if you do have any reactions.
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