Wufoo
Lavish...by C. Davis New Client Questionnaire
This is my form. Please fill it out. It's awesome!
Name
*
First
Last
Date
*
MM
/
DD
/
YYYY
Email
*
Pre-Lash Questions
*
Yes
No
Loved them
Hated them
Have you worn individual lashes before?
1
2
3
4
If yes, how did you like them?
1
2
3
4
Do you rub your eyes often?
1
2
3
4
Do your eyes tend to "tear up" or water?
1
2
3
4
Do you take steamy showers? i.e. foggy mirrors
1
2
3
4
Do you use an oven while preparing meals?
1
2
3
4
If you have any eye conditions, please list.
*
Maximum Allowed:
140
characters.
Currently Used:
0
characters.
How do you sleep? i.e. back, side, stomach, etc.
*
When cleansing your skin, do you use your hands or a face cloth?
*
Lavish...by C. Davis Cancellation Policy: Any appointments cancelled less than 24 hours will have an additional $10 charge added on to the next service. Any appointments cancelled on the same day will have an additional $15 charge added on to the next service.
READ THIS STATEMENT CAREFULLY: Individual lashes can last up to two (2) weeks depending on your lifestyle. Lashes shed every fourty-two (42) days. It is possible, however, that an individual lash is placed on a lash that is ready to shed. Lavish...by C. Davis does reserve the right to be selective. By typing your name below, you acknowledge that you have read and understand this statement and that Lavish...by C. Davis will not be held liable for any conditions pertaining or related to the well being of your eyes.
*
First
Last
Do Not Fill This Out
Wufoo
Powered