• Format: (000) 000-0000.
  • How did you hear about us?*

  • Health History

    Please check off any that may apply to you within the last 6 months:
  • Please check any of the following that applies to you:*
  • Have you ever had eyelashes extension before?*
  • Would you like to have a patch test? (Note that a patch test does not guarantee that an adverse reaction will never happened)*

  • Photo Waiver Release Form

    [Check this box if you grant permission for photographs or videos to be taken during the procedure for promotional or educational purposes.]

  • By signing below, I acknowledge that I have read and understand the terms of this photo waiver consent form and voluntarily agree to its contents.

  • Date
     - -
  • Date
     - -

  • Consent Form

  • By signing this release, I acknowledge that I have been given the full opportunity to ask any and all questions regarding the lash services provided by Iconik Beauty Studio (hereafter referred to as the "Technician").*

  • By signing below, I acknowledge that I have read and understand the terms of this consent form and voluntarily agree to its contents.

  • Date
     - -
  • Date
     - -
  • Should be Empty: