Client Consultation Forms

Name

First NameLast Name

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Birth Date

( Client must be 18years old or older )

What service are you receiving?

Have you ever had any of the service checked above before ? ( If yes, when was your last appointment? )

If this question doesn’t apply to the service you are receiving please write “does not apply” in the field .

Have you had any allergic reactions? ( If yes, please be specific)

This includes Glues , Tapes or anything related to lashes

Are you currently wearing contact lenses today?

Yes or No. If this question doesn’t apply to the service you are receiving please write “does not apply” in the field .

Are you currently using any eye drops over the counter or prescribed by your eye doctor?

If so what kind of eye drops? If this question doesn’t apply to the service you are receiving please write “does not apply” in the field .

Select the following statements prior to your service

Please Read and Check the Following Statement

• I agree to follow the aftercare instructions provided by SBK to ensure the longevity and health of my eyelash extensions or the health of my skin. I acknowledge that there are risks associated with the application of the service that I will be receiving today, including but not limited to eye irritation, discomfort, and allergic reactions. I have disclosed all relevant health information to the technician. I understand that SBK is not responsible for any adverse reactions or damages that may occur as a result of failing to follow aftercare instructions or disclosing accurate health information. I understand that a non-refundable deposit is required to secure my appointment, and I agree to the cancellation and rescheduling policies of SBK Beauty and Lash Studio. I agree that photos may be taken for record-keeping and promotional purposes. I acknowledge that I have read and fully understand this agreement and release form. I am signing it voluntarily and with full knowledge of its significance.

This agreement will remain in effect for this procedure; and all future follow up’s conducted by SBK. I read English and understand that this consent agreement is legal and binding. I have read and fully understand all information I received. I am over 18 years of age and consent to the agreement and the service. I have read the above information and have given accurate information. If I have any questions or concern, I will address SBK. I give my lash technician SBK permission to perform my eyelash procedures and will hold SBK harmless from any liability that may result from this treatment. I understand that the information herein is to aid SBK in giving better service and is completely confidential. I understand that SBK is an licensed professional that is highly educated and will take precautions to minimize or eliminate negative reactions as much as possible.

Signature

Client Consent Form