Lash/Brow Tinting Consultation Form

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You must be over 18 years of age to complete this form. If you are under 18 years of age, a parent/guardian must complete this form on your behalf, plus the Parental Consent Form.

Why élégant nails need the information and how it is used:

At élégant nails, I take your privacy seriously. For health and safety of clients, I maintain records of any health and/or medical conditions, which may indicate that a particular service or treatment would not go ahead (eg allergies, pregnancy, skin conditions), or a particular product should not be used.

Please note that this form must be kept for a minimum of 7 years from your last treatment for insurance purposes and require clients to complete and submit this form before any treatment takes place. In the case of minors, this will be 7 years AFTER they reach the age of 18.

Clients records from this form are stored on the secure Cloud on Google Forms or on an encrypted computer. Please read the privacy policy at https://elegant-nails.co.uk/policy-documents for more details.

The health records are only used in relation to treatments and service by élégant nails and not used for any other purpose.

Email *

Select your preferred tint colour: *

Black(1)

Blue/Black(2)

Blue(3)

Grey(4)

Brown(5)

Light Brown(6)

Required

Tinting treatment required *

Eyelash tint

Eyebrow tint

Eyelash & Eyebrow tint

Required

INFORMATION & AFTERCARE ADVICE (Please tick each statement to confirm you understand the information and advice regarding your treatment): *

Tinting is designed to enhance the look of your natural lashes/brows, which can last between 3-4 weeks;

The tinting procedure is painless;

Depending on the treatment type, a maintenance program may be required;

AVOID direct contact with water to the area, hot steam, sauna or swimming pools for 24hrs after your tinting treatment;

For 24hrs, avoid rubbing and touching your eyes/eyebrows, do not apply makeup and avoid sleeping on that area;

Oil-based makeup removers may strip the tint on your eyelashes/eyebrows quicker than non-oil based remover;

Do not use the sauna or face steamer every day

Required

Is there anything that you’d like to make élégant nails aware of before attending your appointment? *

I have read and understood the above information and aftercare advice and agree that I am responsible for the general care of my eyelashes/eyebrows after treatment.

PATCH TEST PROCEDURE - I understand that it is an insurance requirement for a patch test to be completed 48hrs prior to my full treatment and at 6 monthly intervals.

Patch Test completed on: *

YYYY

Did a reaction occur from your Patch Test (or since your last treatment)? *

Yes

Maybe

Other:

Required

Full Name: *

Parent/Guardian Name (if required):

Contact Number: *

Date of completion: *

YYYY

A copy of your responses will be emailed to the address you provided.

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