top of page

Untitled (50 × 10 in) (50 × 5 in) (50 × 2 in) (2).png

Home
About us
- Gallery
- Blog
Class/Programs
Online Certifications
Shop Online
Forms
Manicure Consent form
Hair Service Consent Form
Microblading Consent Form
More

Use tab to navigate through the menu items.

Salon & Academy

3D Lash & Brow

Book Student Services

Book a School Tour

View classes

SHOP PRODUCTS

3D Lash & Brow Salon & Academy

Facial Consent Form

First Name

Email Address

Phone

Last Name

Address

DOB

Emergency Contact

Phone

Do you have any health problems or concerns that I need to be aware of before treatment, If the answer is yes, please describe?

Do you have any allergies?

Any recent surgery on your face, neck, and shoulders?

Are you currently, or have you used Retin-A, Renova, Resorcinol, or any powerful alpha hydroxyl Acids within the past 3 months?

Yes

If YES, please explain?

Are you using any other skin thinning products or drugs?

If YES, please explain?

Are you a diabetic?

Yes

Are you a diabetic?

Yes

Do you use a tanning bed?

Yes

Do you currently wear contact lenses?

Yes

Are you exposed to the sun daily or will you spend more time out in the sun anytime soon?

Have you experienced Botox, Restylane or Collagen injections?

Please select the following conditions you have/had experienced?

Pacemaker or pins in bones

Metal plate

Warts

Cold sores

Lupus

High/Low blood pressure

Cancer

Anemia

Epilepsy

Hepatitis

Asthma

Seizures

Stroke

Headaches

Pregnant

Easy bruising

Skin infections

Accident or trauma

None

I declare that the info I’ve provided is accurate & complete

Today's Date

Select an option

Choice 1

Choice 2

Choice 3

Heading 1

Thanks for submitting!

Home

About

Book Now

469-917-9305

4230 LBJ Freeway, Suite 122

Dallas, Texas, 75244

Classes

bottom of page