Eyelash extension record


EYELASH EXTENSION RECORD CARD
& CLIENT INFORMA TION

Client's Name:
Date:
Address:
Tel No:
Mob:

OTHER PROD UCTS

Yes No
Do you wear glasses?
Do you wear contact lenses?
Have you ever had eyelash extension before ?
Do you leave any allergies/ sensitivity?
Any eye problems in the past 4 weeks?
Do you use any eye products e.g. drops?
Do you perm or tint your lashes?
MEDICAL HISTORY
MEDICATION DETAILS

NATURAL LASHES INFORMATION

Natural Eye Shape:
Round:
Almond:
Deep Set:
Texture:
Fine:
Medium:
Coarse:
Natural Eyelash Shape: Straight Curly Mixed
Natural Lash Arrangeiment: Gaps Sparse Full
EYELASH DESIGN


SKIN SENSITIVE TEST (Optional Requirement)
Date skin sensitivity test performed:
Area performed
N.B Do NOT perform treatment if client In as a positive +VE reaction to the test e.g. swelling, itching, redness
CLIENT'S REQUIREMENTS