Consultation Form
Please fill out this form to register for lash extension services and provide necessary information for your appointment.
Client Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
*
-
Do you have any known allergies?
*
Yes
No
If yes, please list your allergies (including adhesive, latex, or other relevant allergies):
Would you like to have a patch test before your lash extension appointment?
*
Yes, I want a patch test
No, I do not want a patch test
Do you consent to photos/videos of your lash extensions being shared on social media for promotional purposes?
*
Yes, I consent
No, I do not consent
Mood
*
Chatty
Quiet time/ Nap time
Open to a bit of both
Other
Please choose your desired lash style from the photo below
*
Cat
Natural
Doll
Open
Signature (Please sign to confirm the accuracy of your information and your agreement with the above consents and disclaimers)
*
Submit Form
Submit Form
Should be Empty: