Lash Consent Form - Alison Andrews Spa printable pdf download

Lash Consent Form - Alison Andrews Spa

Eyelash Extension Consent Form - Alison Andrews Day Spa

I have agreed to have eyelash extensions applied and/or removed from my eyelashes. Before

my professional eyelash technician can perform this procedure, I understand I must complete

this agreement and provide my consent by signing and dating this consent form.

Client Information:

Name:

___________________________________________________________________________

Address:

_________________________________________________________________________

City:________________________________State:_______

Zip:_______________

Phone: ___________________________

Email:________________________________________

How did you hear about

us:__________________________________________________________

Birthday: Month and Day : _______Month _______Day ( we have birthday coupons! )

Is this your first time having Eyelash Extensions? ____Yes _____No

If yes, please let us know about your experience and approximately how long ago you had your

last

service.________________________________________________________________________

______________________________________________________________________________

___________

Are you having lash extensions applied for: _______Special Occasion -or- _______Daily Wear

Do you wear Contacts? ______Yes ______ No

Do you have ANY make up around your eyes today? ________Yes _______No

Do you often rub, pull or pick your lashes for any reason? _____ Yes _______ No

Do you have , or are you being treated for any eye illness or injury? ______ Yes ______ No

Please list any eye drops or eye medication you are currently using._______________________

Are you able to lay on your back for 2 hours to have your lashes applied? ______Yes _____No

Lash Consent Form - Alison Andrews Spa