Eyelash extensions
Please fill out the following health declaration form in order to book a treatment with me. Submissions has to be done prior your booking. Thank you for taking your time to do that. I will check and get in touch, if any concerns. Looking forward to pampering you soon. Patch test has to be booked upfront 24/48 hrs and no waivers accepted !!!
I agree to inform immediately, if my body temperature is getting higher than 37°C, develop a cough or loose my sense of taste and smell in the last 24 hrs prior the treatment.
Are you wearing contact lenses?
Yes
No
If YES, elaborate more
Have you had eyelash extensions before?
Yes
No
If YES, elaborate more
Do you have any allergies?
Yes
No
If YES, elaborate more
Any eye problems in the past few weeks?
Yes
No
If YES, elaborate more
Do you tint or perm your lashes?
Yes
No
If YES, elaborate more
Do you use any eye products eg. drops?
Yes
No
If YES, elaborate more
Pregnancy
Yes
No
If YES, elaborate more
First Name
Last Name
Email
Phone Number
Address
Please leave instructions for parking. I am caring heavy equipment, so free immediate parking to the property is required.
Please upload a doctors notes, if you have medical condition and require adapting on your treatments
Select a File
I agree to the book consultation and patch test minimum of 24hrs before your treatment otherwise I can not perform your treatment
I agree to the terms & conditions and I confirm that the information given in this form is true
Submit
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