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How did you hear about us?
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Master Affiliate (Skin-Brows-Lashes) - Jena
Master Affiliate (PMU) - Mita
Other or Referrals Name
General availability notes / special event date?
WAX SERVICE REQUESTED
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LASH SERVICE REQUESTED
Do you have extensions on now?
I have never had extensions
I have none on now
A few are left
Many are still on
What Level Fullness / Service do you want to book?
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 - Natural Russian Volume Full Set (2-3D)
Level 5 - Full Russian Volume Full Set (up to 6D)
Non Client Fill - Classic
Non-Client Fill - Hybrid (Mixed)
Non-Client Fill - Volume
I don't know and need advice
Add on Service
Dry Eyes? Therapeutic Eye Spa Massage
Patch Test - $25
Any conditions or active health related issues that could be area for concern?
Please tell us if you have any active infections, allergies, eye conditions, auto-immune disease, hormone related therapy or medications that may cause you to have a hyper sensitivity to this service. If you have undergone recent surgery or chemo, please let us know.
Do you qualify for any of the following?
Other Voucher/Certificate (see below)
Offers cannot be combined and must be added at the time of booking
If you have a discount, please provide info here prior to confirmation
Not all offers are applicable for all artists.
Any of these situations?
Burning during appointment
Burning after appointment
Lashes don't stay on
None of the above
LASH DESIGN OPTIONS
How involved in design do you care to be?
Very involved. (Video consult recommended)
Minimal involvement (we will use answers on this intake form)
See my design thoughts below, but I'll trust my artist.
Do you want to schedule a FREE video consultation?
I don't want more fullness.
I want the same fullness as my natural lashes but a little darker
I want more fullness than I naturally have
I want a very full look, but not quite strip lash
I want a strip lash look
Natural - same shaping as my natural lashes now
Doll - open eye look with more length in the center
Cat - elongated look with length in outer corners
Same as my length
Slightly longer than my length
A lot longer than my length
Brown - lighter option
Soft Black - looking for a natural look
Black Black - not looking for a natural look
Real Mink Fur - for think damaged lashes
Slight curve, very subtle from the front. More obvious from sides. more visible from sides, good to downplay very round eyes
Curled, standard curl visible from front & sides
Curly, lash curler look
Very Curly, specialty curl good for some flatter eyeshapes
Describe your eyes/lashes:
Describe your eyeshape or notes about your lashes or anything you want us to know re: your preferences
Select to indicate acknowledgement of all:
24 hour cancellation policy
Fill = no more than 1/2 gone
No cash refunds on labor
Design changes available on first fill
Original artist subject to availability
Artist may take before & after's
Gratuity appreciated in cash
I do not agree to 1 or more of the above
Lash Academy - Call me if you need volunteer model
SAN FRANCISCO CALL (888) 406-5274 | TEXT 415-518-5274
ABOUT YOUR VISIT