Name
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First Name
Last Name
Email
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How did you hear about us?
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Word of mouth
Local drive by
Local noticeboards
Facebook
Instagram
What treatment are you booking in?
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Brow Design (wax and tint/dye)
Brow Design + Lamination
Brow Shape only
I'm not sure
What treatment have you had in the past?
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Brow Wax
Brow Tint/Dye
Brow Tint/Dye + Wax + Lamintation
Just Brow Lamination alone
Both Brow Wax & Tint/Dye
No previous treatments ever
How did you go with your previous treatments? Was there anything that you disliked or liked?
Are you taking any skin medication (i.e. accutane)? Please list below how long you have been not taking the medication for if no longer on it
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Are you currently using any skincare producted in your routine such as applying AHA, BHA, Retinol (ex. anti-aging skin prosecutors)
Please tick the box below If any of these apply to you
Psoriasis
Eczema
Alopecia
Sunburn
Ultra-Sensitive Skin
Wounds or Scar Tissue in the treatment area
Acne or active pimples in the brow area
Have you ever had any allergic reaction to any sort of beauty treatment or product before?
I will advise the brow stylist/artist of any discomfort, irritation, and/or discomfort immediately.
Yes I understand
No I do not understand and wish to be contacted about this
I understand individual responses to product used for our waxing, brow dye/tint and brow lamination and may vary - should a reaction occur, it is my responsibility to contact the salon immediately if any reaction was to occur
Yes I understand
No I do not understand
I understand that I have to lay down for a period of 15 mins for a brow wax, 30 mins for a brow design and 1 hour for brow lamination and brow design
Yes I understand
No I do not understand and wish to be contacted about this
I understand that any small red dots/ pimples are a normal response after a Brow Wax/Shape but this can be avoided so please let the therapist know if this does occur after a treatment
Yes I do understand
No I do not understand and wish to be contacted about this
I confirm, I have not had any semi-permanent make-up procedure on my Brows for at least 8 weeks.
Yes I understand have have not
I have had the procedure performed in the last 8 weeks
I understand I can not have had any skin treatments on my face for at least 4 weeks and have not been on any medication that can affect the skin (such as Accutane) for at least 6 months.
yes I understand
I do not understand and wish to be contacted about this
Are you breastfeeding or pregnant?
Both
Pregnant
Breastfeeding
None
I understand and accept that Brow Lamination is an Alkaline based perm, so it is very strong. It is not suitable for clients with chemically damaged hair or extremely curly hair, as it can damage it further or cause unpredictable results. If the stylist/artist finds determines my brow hairs are damaged or is too curly, the stylist/artist may decide to not proceed with service with an explanation to the client
Yes I understand
No I do not understand and wish to be contacted about this
I understand as a part of the aftercare I am required to purchase an aftercare hydrating serum to put on my brows at an extra cost on top of the service fee itself. This is in the best interest of the client and to get the best results
Yes I understand
No I do not understand and wish to be contacted about this
I understand and accept that some mild but normal symptoms may occur depending on the sensitivity of my skin during the procedure and will subside within 24 hours. These symptoms include: Mild tingling ,Slight redness due to brushing brow hairs back and forth, Slightly warm in the area
Yes I understand
No I do not understand and I wish to be contacted about this
I acknowledge that on a rare occurrence of the following potential health/medical risks associated with receiving brow lamination and/or tint and still wish to proceed with the procedures mentioned herein: (a) Allergic reaction symptoms: itching, severe burning, skin flaking or peeling, inflammation, blisters
Yes I understand
No I do not understand and wish to be contacted about this
I understand and agree to follow the after-care instructions and for any unexpected circumstance that happen due to not following these instructions are in my own risk and Wink Lashes and Beauty are not entitled to fix any service due to lack of aftercare followed by client
Yes I understand
No I do no understand and wish to be contacted about this
I understand that the longevity of my tint/dye may vary from client to client depending on lifestyle, skin cycle and aftercare
Yes I understand
No I do not understand and wish to be contacted about this
I understand I am allowed to bring in a photo of my brows drawn in to the shade I am hoping to get to further help the brow technician to achieve desired results
Yes I understand
No I do not and wish to be contacted about this
I understand that for the best lasting results I am required to exfoliate my brow area myself 1-2 days leading up to my appointment with a brush provided by the salon
Yes I understand
No I do not understand and wish to be contacted about this
Do you prefer a silent treatment with my therapist or happy to have conversation throughout?
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What is the most important to you about your treatment booked? What would make your leave your appointment completely satisified?
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I understand I am completely welcome to bring headphones into my appointment to list to a device during the treatment
Yes I understand
I'm good thanks
Is there any other treatment that you think is important to us that we need to know? Please list below
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Thankyou so much for filling this form out. All your information is completely confidential and is only visible to Wink Lashes and Beauty staff. .We look forward to seeing you at your appointment x