Treatment Consultation Card Treatment Consultation Card Please tick which treatment you are having: HD Brows Henna Brows Brow Lamination LVL Lashes Lash Tint Name * Full address * Phone * Date of birth (DD/MM/YYYY) * GP’s address * Please list any medical conditions or allergies Please list any medication you are taking Please list any past reactions to beauty or aesthetic treatments or products Are you pregnant? * Yes No Has a patch test been performed? * Yes No Please confirm that the information given above is correct and that you have been given treatment information and advice for the treatment Yes, I confirm Before and after picture consent – we occasionally take pictures of brows, lashes and nails for social media promotion. Do you give us permission to use such photos? * YES, feel free to use them NO, please do not use them Signature (type your name) * Date (DD/MM/YYYY) * Submit If you are human, leave this field blank.