Brow and Lash Extension Client Check In

Client Check In

Please fill out this form in it's entirety.
Important Update: All services (excluding Microcurrent and Brows) will increase 5–8% effective April 1, 2026.
Name

First NameLast Name
Service you are receiving today (Check all that apply).
Important Update: All services (excluding Microcurrent and Brows) will increase 5–8% effective April 1, 2026.
I confirm, to the best of my knowledge, that the answers I have given are correct and that I have not withheld any information that may be relevant to my treatment. If I have withheld any information, I understand that I will not hold my Esthetician responsible for adverse reactions, injury or unfavorable results. By checking "I agree" below, I acknowledge and agree to all terms.
Should be Empty: