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CONSENT FORMS

EYELASHES

Photography consent & release form

Health declaration

Please fill out the following form.

Date of birth
Month
Day
Year
Are you taking any medications?
No
Yes
Are you suffering from a medical condition, illness or injury?
No
Yes
Any Allergies? (Oils, lotions, nuts, fruits,etc?
No
Yes
Are you pregnant ?
No
Yes
Are currently under medical supervision or other medical interventions?
No
Yes
Areas of broken skin or joint replacement?
No
Yes

Let’s Work Together

Get in touch so we can start working together.

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Thanks for submitting!

CONTACT
US

Call or Text: 347.904.1038

Monday - Friday: 9:00 AM- 7:00 PM

Saturday: 9:00 AM- 5:00 PM

Sunday: Closed

VISIT
US

590 Old Country Road

Westbury NY 11590

 

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Lash & Spa

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