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PINKY INKY TATTOO

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Eyelash Consultation Form

* Indicates required field

Have you done lash lift before? *

No, this is my first time Yes, less than 4 weeks Yes, 4 - 8 weeks Yes, more than 8 weeks

If so, have you had any reaction or damage from lash lift before? *

What is the best way to describe your lash condition? (Check all that apply) *

Fine Medium Coarse Short Long Straight down

Do you need allergic skin test? *

Yes No

Do you have any eye injury, eye illness or eye infection? *

Yes No

Do you have any skin trauma, swelling, redness, lesions, inflamation or abrasions around the eyes area? *

Yes No

Do you have any skin disorders or diseases, including pustular, cystic, or othe acne around the eyes area? *

Yes No

Do you have autoimmune skin disorders such as eczema or psoriasis around the eyes area? *

Yes No

Do you wear contacts? If so, please remove them for a lash lift/tint service *

Yes No

Do you have hypersensitive skin (is easily irritated)? *

Yes No

Do you have alopecia (baldness) of the lash area? *

Yes No

Are you allergic to anything else? *

Are you pregnant or lactating? *

Yes No

Do you have any hormonal imbalances? *

Yes No

Have you had your eyelid tattooed recently? *

Yes No

Name *

First

Last

Email *

Phone Number *

When is the best time to book your appointment? *

* Please Note Skin Test Is Not Intended To Diagnose, Treat, Cure, or Prevent Any Condition.
* All Results Will Vary Per Person Depending On Lash Condition, Skin Type, Lifestyle, Any Medication Taken, And Aftercare.
* We Do Not Provide Service For Pregnant And Lactating Persons.

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Home
Gallery
Meet KiKi
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Q & A
FYI