Client form

Client's Name

First NameLast Name

Mobile Number

Home Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Email

Date of birth

DD-MM-YYYY

Instagram handle

DD-MM-YYYY

Emergency contact

Name

Street Address Line 2

Number

Please select the service you wish to book (select one)

Please select a Lash Shape you prefer:

Please select a lash curl you prefer:

Please select a lash length you prefer:

Do you have any known sensitivities or allergies to the following: (Please select below)

Have you had this service before?

Do you wear glasses or contacts? Please ensure to remove contacts for the appointment.

Are you pregnant or nursing?

Have you recently had a lash lift? Within 6 weeks

Reason for getting lashes?

If you had negative reaction with eyelash extension, please state the reaction/experience.

I understand this procedure requires single synthetic eyelashes to be glued on my own natural eyelashes

I understand that it is my responsibility to keep my eyes closed still during the entire procedure, until my eyelash technician tells me to open my eyes

I understand that some risks of this procedure may be not limited to eye redness and irritation. The fumes from the adhesive may cause my eyes to tear up if I open my eyes.

I understand that because of the natural lash cycle and wear and tear, I will need to maintain my extensions with touch up appointments usually recommended about 2 to 3 weeks to keep them full

I understand that I am required to follow the eyelash aftercare instructions in order to maintain the life of these eyelash extensions

I agree that by reading and signing this consent form, I release Kvm.studio from any claims or damages of any nature.

I understand that I am required to follow the eyelash aftercare instructions in order to maintain the life of these eyelash extensions

I understand that photos and videos will be taken and I consent for them to be used for marketing purposes.

Items you wish to discuss

PLEASE READ THE FOLLOWING CAREFULLY

I understand that having eyelash extensions applied may have some risk of irritation to the orbital eye area, including, but not limited to the eye itself. Some cases may result in eye redness, a stinging or burning sensation, blurred vision, irritation, or allergic reaction to the adhesive, under eye patches, or other products used.

I understand that it is my responsibility to remain still during the application and to keep my eyes closed unless otherwise advised.

I understand that if any solution gets in my eye, then my eye will be flushed with sterile eyewash and medical attention may be required.

I understand that natural eyelashes have a growth cycle, and my natural eyelashes grow and shed. Receiving consistent refills is required to keep the full appearance and protect the integrity of the natural eyelashes. I understand that maintenance is recommended every 2-3 weeks.

I understand the “TOUCH UP” sessions. If I feel as if there is a problem with my lash shedding e.g., majority of my lashes have fallen out within 1-2 days; I will contact KVM Studio in which may result in an offer for a complementary fix. Anything after 72 hours’ notice will strictly be considered as a touch-up appointment with charges. WORK FROM ANOTHER ARTIST will not be accepted. A removal will be required with a new set.

I understand that for the purposes of documentation “before and after” photographs will be taken. These photos are kept in my file and not shared without my permission.

I give KVM. Studio permission to use photographs taken of me for advertisement and training purposes or portfolio development on social media.

By signing below, I have read the above information. If I have any concerns, I will address these with my stylist immediately. I give permission to my stylist to perform the procedure we have discussed and will hold KVM.Studio harmless from any liability that may result from this treatment. I have accurately answered the questions on the Client Intake Form, including all known allergies, prescription drugs, or products I am currently ingesting or using topically. I understand my stylist will take every precaution to minimize or eliminate negative reactions. If I have additional questions or concerns regarding my treatment, I will consult my stylist immediately. I agree that this constitutes full disclosure, and that it supersedes any previous verbal or written disclosures. I certify that I have read, and fully understand, the above paragraphs and that I had sufficient opportunity for discussion of the process and all my questions are answered. I understand the service and accept the risks. I do not hold the stylist, responsible for any of my conditions that were present, but not disclosed at the time of this eyelash extension service, which may be affected by the treatment performed today. I acknowledge this agreement for all eyelash extension services received commencing from the signing date.

Client Signature

Date Signed

Date