Eyelashes Extension Client Record Form – Fill Out and Use This PDF

The Eyelash Extension Client Record Form is a comprehensive document designed to capture essential information from clients seeking eyelash extension services. It collects data ranging from personal details and contact information to health history, specific eyelash service preferences, and allergies, ensuring a tailored and safe aesthetic enhancement. For personalized and meticulous eyelash extension services that prioritize your safety and aesthetic preferences, fill out the form by clicking the button below.

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Eyelashes Extension Client Record Form PDF Details

Welcome to a deep dive into the significance of the Eyelash Extension Client Record Form, a vital tool in the beauty industry that bridges the information gap between technicians and clients. At its core, this form meticulously collects client details such as name, date of birth, contact information, and reasons for their visit, enhancing the personalization of service. Additionally, it delves into the medical and aesthetic history of the client, touching on any previous eyelash extensions and their experiences, to tailor the treatment to their specific needs. Critical health-related questions are posed to identify potential contraindications, ensuring the safety and well-being of the client during and after the application process. Questions regarding lifestyle and daily habits offer insights that could impact the longevity and appearance of the eyelash extensions, facilitating a more durable and satisfying outcome. This comprehensive approach, aided by the client's disclosures about allergies, medication, and previous cosmetic procedures, allows for a customized service that prioritizes client satisfaction while minimizing risks. In doing so, the Eyelash Extension Client Record Form emerges as an indispensable part of the eyelash extension service, promoting a seamless integration of beauty enhancement with health and safety standards.

Question	Answer
Form Name	Eyelashes Extension Client Record Form
Form Length	1 pages
Fillable?	No
Fillable fields	0
Avg. time to fill out	15 sec
Other names	wax brow lashes client information sheet, client consultation form for eyelash ext, lash client record pdf, printable eyelash client record cards

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EYELASH EXTENSIONS INTAKE FORM

Name:

DOB:

Age:

Gender:

Address:

City:

State:

Zip Code:

Home Phone:

Cell:

Work:

Email Address:

Occupation:

(Your email address will be used for appointment confirmations, quarterly newsletters, and to alert you of specials and promotions.)

How were you originally referred to Bella Via? (Please circle and add note if applicable.)

Dr. Colville Dr. Zavell Website Friend:

Other:


		AREA SPECIFICS
Is this the first time that you have had eyelash extensions applied?				YES	NO
If no, where did you have them applied?
Please indicate if you have worn any of the following types of eyelashes within the last 60 days:
□ Individual	□ Strip	□ Flare	□ Other
Do you do any of the following to your eyelashes? (Please check all that apply.) □ curl					□ perm	□ tint
Are you having eyelash extensions applied for: □			daily wear	□ a special occasion
Do you wear contacts?	YES	NO
Do you habitually rub, pull, or pick your eyelashes for any reason?				YES	NO
Do you have, or are you being treated for, any eye illness or injury?				YES	NO
What side do you predominately sleep on?				RIGHT	LEFT

Please list any eye drops or eye medications that you are currently using:

Do you have any allergies to adhesives, tape, paper tape or synthetics?	YES	NO
If so, please list your reaction(s):
Are you able to keep your eyes closed and lie still for up 2 hours or longer?	YES	NO

Please check any of the following that apply to you:

□ Lasik Eye Surgery	□ Dry Eye	□ Permanent Cosmetics	□ Blepharoplasty
□ Microdermabrasion	□ Seasonal Allergies	□ Alopecia	□ Thyroid Diseases
□ Glycerin Allergies	□ Iron Deficiency	□ Ringworm	□ Major Surgery
□ Eating Disorders	□ Oral Contraceptives	□ Anticoagulants	□ Retinoids
□ Accutane	□ Beta-adrenergic Blockers	□ Chemotherapeutic Agents	□ Hormonal Imbalance
□ Recent High Fever	□ Severe Illness	□ Flu Symptoms	□ Extreme Stress
□ Drugs that Cause Hair Loss		□ Childbirth within the last 120 days

□Exposure to Chemicals in Swimming Pools, Bleach, Hair Dye, or Perms

□Hypersensitivity to Cyanoacrylate or Formaldehyde

How to Edit Eyelashes Extension Client Record Form Online for Free

wax brow lashes client information sheet can be filled out with ease. Simply open FormsPal PDF editor to perform the job in a timely fashion. Our editor is constantly developing to grant the very best user experience attainable, and that's thanks to our resolve for continuous enhancement and listening closely to customer opinions. To get the process started, take these basic steps:

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It will be easy to finish the document with our practical guide! This is what you want to do:

1. Start filling out the wax brow lashes client information sheet with a selection of essential fields. Collect all of the necessary information and make certain absolutely nothing is omitted!

Step number 1 for submitting printable eyelash extension client record cards

2. After filling in the last part, go to the next part and enter the essential particulars in all these blanks - Is this the first time that you, Do you wear contacts Do you, YES NO, YES YES RIGHT, NO NO LEFT, Please list any eye drops or eye, Do you have any allergies to, YES, Are you able to keep your eyes, Dry Eye Seasonal Allergies Iron, Blepharoplasty Thyroid Diseases, and Permanent Cosmetics Alopecia.

NO NO LEFT, Are you able to keep your eyes, and YES NO of printable eyelash extension client record cards

3. The following portion is focused on Are you able to keep your eyes, Dry Eye Seasonal Allergies Iron, Blepharoplasty Thyroid Diseases, Permanent Cosmetics Alopecia, Extreme Stress, Exposure to Chemicals in Swimming, and Hypersensitivity to Cyanoacrylate - complete all these empty form fields.

Step number 3 for submitting printable eyelash extension client record cards

Be really mindful when filling out Permanent Cosmetics Alopecia and Hypersensitivity to Cyanoacrylate, as this is the part where most people make a few mistakes.

Step 3: Once you have glanced through the information in the document, press "Done" to finalize your document generation. Right after registering afree trial account at FormsPal, it will be possible to download wax brow lashes client information sheet or email it directly. The PDF document will also be easily accessible via your personal account with your changes. FormsPal is focused on the privacy of our users; we make sure all personal information coming through our system continues to be secure.

Eyelashes Extension Client Record Form – Fill Out and Use This PDF

Eyelashes Extension Client Record Form PDF Details

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How to Edit Eyelashes Extension Client Record Form Online for Free

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