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NEW CLIENT REQUEST
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CONTACT
Name
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First
Last
Email
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Mobile Number
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Instagram
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SERVICE
Check all that Apply
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Master Artist ONLY
Tier 2 Artist ONLY
Primary Lash Services
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Please select a Service
Level 1 - Classic: Natural Woman Full Set
Level 2 - Classic: Natural Diva Full Set
Level 3 - Hybrid: Classic + Volume Mixed Full Set
Level 4 - Double Volume Full Set
Level 5 - Triple Volume Full Set
Non Client Fill
I don't know and need advice
Real Mink Fur Instead of Premium Mink Lashes?
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No
Yes - On my initial full set $99
Yes - Please upgrade me $99
Yes - I am a current mink fill client $21
I don't know
Any Add On Services?
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Bottom Lashes - Lite $25
Bottom Lashes - Full $40
Professional Removal - $25
Colors - $25
I have lashes on now
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No
Yes, a decent amount
Barely any left
If yes, describe any previous reactions or experience
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Availability
Weekdays
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Mornings
Afternoons
Evenings
Available Anytime
Not Available
Weekends
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Mornings
Afternoons
Evenings
Available Anytime
Not Available
Required time range or any days you cannot come?
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Notes on timing for a Special Event?
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How did you hear about us?
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Please select one
Facebook
Instagram
Yelp
Online Search
None of the Above
Referral
Referrals Name
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Lash Academy - Call me if you need volunteer model
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yes
no
Do you have a special voucher or discount of any sort?
*
Yes
No
If yes, voucher number & description
*
PROFILE NOTES
About my preferences. I want...
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longer lashes
darker lashes
a fuller lashline
curlier lashes
a very natural & real look
a more made up, glam look
the look of strip lashes
no preference and flexible to try different looks
About my health. I have...
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a latex allergy
an allergy to acrylic
a thyroid condition
had Radiation / chemo within 1 year
unexplained hair loss
Pregnant
Hormone related medications / therapy
Auto-immune related medications
a lash pulling habit
dry eyes, itchy or red
had a previous reaction
other / general eye sensitivity
None of the above
About the Policies. I agree...
*
Artists take gratuity in cash only
Strict 24 hour cancellation policy
Fills are within 3 weeks & half intact
No cash refunds on labor
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HOME
SERVICES
ABOUT
YOUR VISIT
PRE SERVICE
POST SERVICE
POLICIES
Q & A
GALLERY
CLASSIC
HYBRID
VOLUME
BLOG
CONTACT
