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