Spa Guest Consent + Consultation

Welcome to the Viorè Spa Experience

VIORE' is Columbia's #1 Lash Lounge and Spa that specializes in Lash Extension Application, Brow Enhancement, Body Waxing, Facials and Wellness Discovery for the multifaceted woman. Please fill out our Consent and Consultation form to the best of your ability in order to be serviced. This must be completed to be serviced.
Name*

First NameLast Name
For the safety of you and our staff, please take a photo of your non expired license or ID. Please do not block out any information. We will never share your information, please review our Privacy Policies listed by clicking the Spa Policies & Procedures link above. *
If you are uncomfortable with uploading your license or ID, please take a picture of yourself. Once we review your intake form and see the photo of you, you will only be able to pay with EXACT CASH after your appointment. No exceptions.
List your Emergency Contact please include their *Name + Phone # + Relationship to You**
Please list any medications/supplements you are currently taking. Please be as honest as possible as this can and will affect your lash, brow or skin service results and retention. If inapplicable, enter N/A.*
Please list any topical medications you are currently applying. Ex: Retin-A, Retinol, Accutane. Please be as honest as possible as this can and will affect your lash, brow or skin service results and retention. If inapplicable, enter N/A*
If you are not sure what you are allergic to and experience an reaction, we will not be held responsible.
Are you allergic to any of the following (Please check all that apply):*

LatexCarbon BlackFruits or Fruit ExtractsNone
Please list any and all allergies. For example, if you are allergic to any form of hair dye, you will not be able to get brow or lash tint services. Please be as honest as possible as this can and will affect your lash, brow or skin service results and retention. If inapplicable, enter N/A*
Please list any surgeries you've had in the past five years. If inapplicable, enter N/A.*
Please check if you've ever suffered from any of the following:*

EczemaSunburnSkin CancerCold SoreUncontrolled EpilepsyBlood Borne VirusesPsoriasisConjunctivitisLupusRecent Scar TissuesDiabetesBlood/Circulatory DisorderStyePink EyeNone of the Above
If any of the above was checked, please list the last time you experienced/more information regarding this issue. If inapplicable, enter N/A.*
Are you currently pregnant?*

YesNo
How would you describe your skin?

DryOilyOily, but only in T zoneCombination
General Consultation Section

This section is to get to know a little bit more about the service or style you want. We love to cater each moment to YOU. Fill out the below and we'll always have the mood just right for you!
What Service Did you book?*

Lash ExtensionsFacialBody WaxingBrow Service
If booked a lash service, upload your inspo. Keep in mind, if you have no inspo but are not sure of what you want --- text 803-303-6703 to add on an In Depth Consultation so that we will have enough time to figure it out together!

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What is your main concern regarding the service you booked. For example, if you booked a facial service... what are your skin concerns? Or if you booked lash extensions... what lengths are you thinking about trying? Short, Medium, Long? *
Do you live an active lifestyle? Gym gurlie? Active sports?*

YesNo
Are you willing to invest in home care to maintain your investment such as Lash Shampoo, Facial Products, Waxing and Brow Serums?*

YesNo
If so, what is your budget for home care? (not your service)*

$49.99 & below$50 - $249$250 - $449$450+
Do you smoke tabacco?*

YesNo
Are you in the Sun a lot?*

YesNo
Do you use sunscreen?*

YesNo
If booked a facial, or just want a great skin care plan, list your current skin care routine.
Is there any thing else you'd like for us to know? Put N/A if not.*
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Welcome to the Viorè Spa Experience

General Consultation Section