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Lash Extension Consent And Intake Form

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Lash Extension Consent and Intake Form

Eyelash extension intake and consent form

Page 1

Personal Information

Email*

Full Name*

Phone Number*

Address*

City*

State*

Zip Code*

Date of Birth*

Occupation*

10.

Emergency Contact Name*

11.

Emergency Contact Phone Number*

Description:Get consent and intake information from clients before providing eyelash extension services. This form ensures that clients understand the risks and benefits of the procedure and that they have disclosed any relevant medical information.

Ensure that your clients are fully informed and have given their consent before providing eyelash extension services with this comprehensive intake and consent form. This form covers all the necessary information, including the client's medical history, allergies, and current medications. It also includes a detailed explanation of the risks and benefits of the procedure, ensuring that clients are fully informed before they agree to the service. By using this form, you can protect yourself and your business from liability and ensure that your clients receive the best possible care.

First Name*

Last Name*

Date of Birth*

Select date

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Guardian's First Name*

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Parent Name*

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First Name*

Last Name*

Date of Birth*

Select date

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Balanced For Life: Chiropractic Initial Consultation

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Guardian's First Name*

Guardian's Last Name*

Phone Number*

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Consultant Name*

Parent Name*

Child Name*

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First Name*

Last Name*

Phone Number*

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Full Name*

Phone Number*

Address*

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Email Address*

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Pet's Age*

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