Winks x Sofii
Client Consent & Consultation Form
CLIENT INFORMATION
Full Name
*
First Name
Middle Name
Last Name
Date of Birth
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Instagram / TikTok
Are you 18 years of age or older?
*
Yes
LASH HISTORY
Have you had eyelash extensions before?
*
Yes
No
When was your last lash appointment?
Do you currently have eyelash extensions on?
*
Yes
No
HEALTH, ALLERGIES & SENSITIVITY INFORMATION
Have you ever experienced redness, swelling, itching, burning, irritation, or an allergic reaction from eyelash extensions or lash adhesive?
*
Yes
No
If yes, please explain
Are you currently using any lash growth serums or treatments?
*
Yes
No
If yes, please list lash growth serums or treatments
Do you have any known allergies?
*
Yes
No
If yes, list your allergies
Do you have any known allergies or sensitivities to adhesives, glues, latex, tape, gel pads, cosmetics, skincare products, or beauty products?
*
Yes
No
Unsure
If yes or unsure, please explain
Have you ever experienced an allergic reaction, irritation, swelling, redness, itching, burning, or discomfort from eyelash extensions, lash adhesive, eye pads, tape, or other lash products?
*
Yes
No
If yes, please explain
Eyes & Skin - Please check anything that currently applies
*
Dry eyes
Watery eyes
Sensitive eyes
Eye infections
Eye surgery
Blepharitis
Styes
Chalazion
Allergies
Skin sensitivity
Eczema
Rosacea
Contact dermatitis
None of these
Other
Please provide any additional information (eyes & skin)
Are you currently taking any medications that may affect your skin, eyes, hair, or sensitivity?
*
Yes
No
If yes, list medications
Are you currently taking or using any hormone-related medications, treatments, or birth control? Please provide any information you feel is relevant to your lash service
Are you currently using any lash growth serums, hair-growth treatments, or other products that may affect your natural lashes? If yes, list products affecting natural lashes
Are you currently pregnant or recently postpartum?
*
Yes
No
Are you currently experiencing significant hormonal changes that may affect your lashes, skin, or eyes?
*
Yes
No
Do you wear contact lenses?
*
Yes
No
Have you recently had any eye, facial, cosmetic, or dermatological procedures? If yes, provide the procedure and approximate date
Is there anything else about your allergies, medications, hormones, eyes, skin, or overall health that you believe your lash artist should know before your appointment?
IMPORTANT CLIENT ACKNOWLEDGMENTS
I confirm that I am 18 years of age or older and understand that clients must be 18+ to book or receive services from Winks x Sofii.
*
Yes
I understand that a valid form of identification may be requested to verify my age.
*
Yes
I understand that my lash artist, Winks x Sofii, is a beginner lash artist and is not a licensed cosmetologist or esthetician.
*
Yes
I understand that Winks x Sofii does not represent herself as a licensed esthetician or cosmetologist.
*
Yes
I understand that Winks x Sofii provides lash services as a developing lash artist and is continuing to learn, practice, and improve her techniques.
*
Yes
I understand the nature of the services I am booking and voluntarily choose to receive services from Winks x Sofii.
*
Yes
Initials
*
SERVICE CONSENT
Eyelash extension service understanding
*
I understand that eyelash extension services involve placing extensions near the natural eyelashes and eyes and may involve temporary sensitivity, redness, watering, itching, or irritation.
I understand that individual results may vary depending on my natural lashes, eye shape, lash health, lifestyle, and aftercare.
I understand that Winks x Sofii cannot guarantee a specific result or retention period.
I understand that I should immediately communicate any discomfort, burning, pain, or unusual irritation during my appointment.
I understand that I should not pick, pull, rub, or excessively touch my eyelash extensions.
Aftercare agreement
*
I agree to follow the aftercare instructions provided to me after my appointment.
Medical attention acknowledgment
*
I understand that if I experience severe, persistent, or concerning irritation or an allergic reaction, I should seek appropriate medical attention.
Non-medical provider acknowledgment
*
I understand that Winks x Sofii is not a medical provider and does not diagnose or treat eye or skin conditions.
Service refusal or stop acknowledgment
*
I understand that Winks x Sofii may refuse or stop a service if it is determined that continuing could be unsafe or inappropriate.
Questions and consent acknowledgment
*
I have had the opportunity to ask questions about my service before proceeding.
Client signature
*
Date signed
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
APPOINTMENT & CANCELLATION POLICY
I understand that a deposit is required to secure my appointment.
*
I agree
I understand that my deposit is non-refundable in accordance with Winks x Sofii's cancellation and no-show policies.
*
I agree
I understand that Winks x Sofii has a 15-minute grace period for lateness.
*
I agree
I understand that arriving more than 15 minutes late will be considered a no-show.
*
I agree
I understand that if I arrive more than 15 minutes late and my appointment is considered a no-show, my deposit will be non-refundable.
*
I agree
I understand that arriving within the 15-minute grace period may result in a shortened appointment depending on the amount of time remaining.
*
I agree
I understand that I am responsible for contacting Winks x Sofii as soon as possible if I know I will be late.
*
I agree
I understand that I should provide at least 24 hours' notice if I need to reschedule.
*
I agree
I understand that same-day cancellations, no-shows, and appointments exceeding the 15-minute grace period may result in the loss of my deposit.
*
I agree
I understand that Winks x Sofii reserves the right to refuse or reschedule an appointment when necessary.
*
I agree
FINAL CLIENT CONSENT
Acknowledgments
*
I have read and understood this Client Consent & Consultation Form.
I have answered all questions truthfully and completely.
I understand Winks x Sofii's policies.
I understand that my lash artist is not a licensed cosmetologist or esthetician.
I understand that I must be 18 years or older to book and receive services.
I voluntarily consent to receive lash services from Winks x Sofii.
Client Signature
*
Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Consent Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Questions, Comments & Concerns
Submit
Submit
Should be Empty: