Client Intake Form

Please fill out the form before your appointment

Brows Form

Do you use or have recently used the following products?
Further assestment
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Lashes Form

Do you have any allergies to the following?
Have you had or used any of the following in the last 4 weeks?
Please note that medications used to treat the following conditions may cause hair/natural eyelash loss. If you are on medications to treat any of the following, please mark them below:
Please mark all conditions that apply:
Thanks for submitting!