top of page
Have an account?

FFBC Lash Intake

Client Information

Health History

Do you wear contact lenses?
Yes
No

You will need to remove contacts prior to service. I can provide small glass jars and contact solution for storage during the service. Please bring a secondary pair or wear glasses, if preferred.

Do you have any allergies, especially to ingredients in cosmetics or adhesives?
Yes
No
Unsure

If you have had a reaction to any adhesives, perm solutions or tint/dye, please be sure to explain what happened.

Have you had any previous eye treatments or surgeries?
Yes
No
Are you currently taking any medications, vitamins/supplements?
Yes
No
Have you been diagnosed with any autoimmune disorders, eye or skin conditions, or have undergone medical treatments?
Yes
No

(ex: hypothyroidism, dry eyes, allergies, rosacea, eye infections, chemotherapy)

Lifestyle

Do you drink caffeine regularly?
Yes
No

PLEASE DO NOT DRINK ANY WITHIN 5 HOURS PRIOR TO YOUR APPOINTMENT.

THIS INCLUDES: COFFEE, TEA, CHOCOLATE, PREWORKOUT, ENERGY DRINKS AND SODA.


IF ABSOLUTELY NECESSSARY, PLEASE KEEP THIS TO A MINIMUM.


Rapid involuntary eye movements are dangerous for the guest and will require rescheduling the service with associated cancelation fees.

Do you:

Selecting any of the above may require additional lash aftercare for extensions for best retention, but does not necessarily prohibit you from having them. Please refrain any of the above as much as possible, especially within 24-48 hours post service.

Is skincare important to you?
Absolutely!
Interested but need help
Not really

PRO TIP: If you wash your face in the shower typically, try doing so out of the shower and wiping product away with a towel to avoid getting onto lash extensions.


AVOID OIL BASED PRODUCTS AROUND THE EYES.


Medical grade, clean, lash extension safe skincare can be purchased. Ask your artist for more info!

Do you wear makeup on a daily/regular basis?
Yes
No
Sometimes

Avoid waterproof or oil based makeup of any kind with extensions. This could be liner, mascara, eyeshadow, concealer and foundation. Bottom mascara that is lash extension safe is available for purchase at your appointment.

Procedure Understanding and Consent

I consent to the following services being performed by FFBC: (Check all that apply)

I understand that the application of lash extensions and the performance of lash lift and tint procedures involve the use of adhesives and other products that may cause irritation or allergic reactions.


I acknowledge that results may vary based on individual factors, and no guarantees have been made regarding the outcome.


I agree to follow all pre-procedure and aftercare instructions provided by FFBC to ensure the best results and minimize potential risks.


I consent to the use of photographs or videos of my lashes for promotional purposes, understanding that my identity will remain confidential unless otherwise agreed upon.

Client Acknowledgment

  • I have provided accurate and complete information to the best of my knowledge.​

  • I have had the opportunity to ask questions and discuss any concerns regarding the procedure and before / aftercare instructions.

  • I consent to the application of lash extensions and the performance of lash lift and tint procedures as described above.

Add a heading

I, the undersigned, acknowledge the inherent risks associated with lash extension, lash lift, and tint procedures, including but not limited to allergic reactions, eye irritation, or damage. By signing this document, I voluntarily assume full responsibility for any injury, damage, or loss that may result from my participation. I hereby waive and release Fearless Femme Beauty Company, its owners, employees, and contractors from any and all liability, past, present, and future, relating to the services provided.

Drawing mode selected. Drawing requires a mouse or touchpad. For keyboard accessibility, select Type or Upload.
Today's Date
Month
Day
Year

- FFBC -

Subscribe to Fearless Fiend Emails

Welcome to your newest obsession.

301.264.6069

1197 N. East Street Frederick, MD 21701

  • Facebook
  • Instagram

©2021 by Fearless Femme Beauty Company.

bottom of page