• Studio Brae

    Client Consultation Form

  • Personal Information

  • Format: (000) 000-0000.
  • Date of Birth
     - -

  • Emergency Contact

  • Format: (000) 000-0000.

  • Medical Information

  • Are you pregnant or breastfeeding?*
  • Do you have any allergies?*
  • Do you have any health concerns?
  • Have you had surgery, botox or filler in the past 6-8 weeks?*
    • Brow Lamination Clients 
    • Have you received a brow lamination before?
    • Have you ever had a reaction to perming solution or hair dye?
    • Have your eyebrows been microbladed or tattooed in the past eight weeks?
    • Are you currently using any AHA, BHA, retinol, retinoid, vitamin A or accutane products? Or had a chemical peel in the past 4 weeks?
    • Lash Lift Clients 
    • Have you received a lash lift before?
    • Have you ever had a reaction to perming solution or hair dye?
    • Do you have a history of dry eyes, sensitive eyes or any other eye conditions?
    • Do you wear contact lenses?
    • Facial Clients 
    • Have you received a facial treatment before?
    • What skincare products are you currently using?
    • What is your skin type?
    • Are you exposed to the sun frequently?
    • Do you bruise easily?
    • Do you react to any known ingredients?
    • Please tick any concerns that apply to you

  • By signing below, you agree to the following:

    I have completed this form truthfully and to the best of my knowledge. I fully consent to the treatment I have booked in for and understand the risks and/or side effects involved. This agreement applies to the date of booking and all future appointment. If any changes occur, I will notify Studio Brae. I understand that this consent agreement is binding and hereby release any persons representing Studio Brae from all claims, demands, damages, actions and cause of action arising out of the performance of the service.

  • Date*
     - -
  • Should be Empty: