NAME ADDRESS MOBILE/LANDLINE NUMBER: QUESTIONS FOR CLIENT Do you wear contact lenses? NO YES Have you had eyelash extensions before? NO YES (specify any reactions or sensitivities) Do you have any allergies? NO YES (specify) Any eye problems in the last 4 weeks? Do you perm or tint your lashes? NO NO Do you use eye products (e.g. drops)? YES YES NO YES(specify) Type of eye makeup remover and mascara PREVIOUS MEDICAL CONDITIONS/SURGERY NATURAL LASH INFORMATION Natural eye shape Round Almond Deep set Natural eyelash texture Fine Medium Coarse Natural eyelash shape Straight Curly Mixed Natural eyelash arrangement Gaps Sparse Full SKIN SENSITIVITY TEST Date: Allergies or reactions: CLIENT'S PREFERENCE Thicker Longer Dramatic Look Long-Term wear Special Ocasion Natural Looks NOTES