Lush Lash OC Client Booking Questionnaire

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Thank you for choosing Lush Lash OC for your professional lash extensions. We provide a
professional and convenient in-home or on-location spa-like lash extension application
experience.

In order to provide our services and welcome you as a client, we need you to fill out this questionnaire in its entirety and agree to abide by our COVID 19 Precaution Rules.

Please be aware of the following:

1. All new/existing clients must not have tested positive for Covid 19, been in contact with anyone that has tested positive for Covid 19, or personally experienced any symptoms as listed within 30 days of requesting services.
2. You will be temperature checked by our lash artist upon arrival to your home. Any false information and/or misrepresentation of your health status, or the health status of anyone you have knowingly been exposed to, which results in our employees/lash technicians being exposed to or contracting any sickness as a result of service to you will result in swift legal action.
3. All clients must wear a face mask upon answering the door to let our lash technician in and during all all times of service and while our lash technician is in your residence.
4. Any additional persons in the home coming within 50 feet of our lash technician must wear a face mask while in the vicinity of our lash technician.
5. We require a CLEAN, open space, SMOKE/DRUG FREE, with adequate and bright lighting in order to provide your service. We provide a lash/massage table and supplies, the client must provide the appropriate place for service to take place in their home or office.
6. We will only operate under safe and sanitary conditions in your home or place of service, if at anytime our lash technician is uncomfortable with the environment, they will leave the premises in order to preserve their safety and well being, your fees will NOT be refunded.
7. Our lash technicians are licensed and skilled professionals that have been practicing the strictest forms of social distancing and Covid precautions in order to keep you (as well as themselves) safe during these uncertain times of the pandemic. Please tip your technician accordingly as they risk their health and livelihood in order to provide you the luxury of this convenient in-home service. We appreciate your cooperation.

You will receive a confirmation email to confirm your appointment time and
date once we have received this form and your $50 booking fee. For additional questions,
please email us at info@lushlashoc.com or text us at 949-543-0350. Thank you so much! -

Lush Lash OC www.lushlashoc.com

Email *

Contact info

Please enter all information completely

First Name *

Last Name *

Phone number *

Date of Birth *

YYYY

Occupation *

Desired date/time for an appointment: *

Address where service is to be performed:

Street Address and suite number: *

City and State *

zip code: *

Clients Home address:

If different from service address.

Street Address and suite number:

City and State

zip code:

Have you had lash extensions before? *

YES

Required

Desired lash service - All fees are in ADDITION to the $50 in-home travel fee *

Full set CLASSIC lash extensions $130 - Adds a natural look of length and some fullness, gives the appearance of wearing mascara.

Full set HYBRID VOLUME $165 - half way between classic and volume gives the look of longer thicker lashes and uses volume fans on some but not all lashes.

Full set Volume Lashes $230 - multiple extensions safe and skillfully are attached to each lash to give the most dramatic and fullness look.

Classic lash fill $75.00 - Fill in and reapplication of new single lash extensions to areas of lash fall out on a previously applied classic set within 2-3 weeks of original full set application. Client must have at least 70% of lash extensions retained to be able to book this service. We do not take new clients for fills, a full set must have been performed by Lush Lash OC within 2-3 weeks of lash fill.

Hybrid Fill $95.00 - Fill in of new single and fan lash extensions to areas of lash fall out on a previously applied Hybrid set within 2-3 weeks of original full set application. Client must have at least 70% of lash extensions retained to be able to book this service. We do not take new clients for fills, a full set must have been performed by Lush Lash OC within 2-3 weeks of lash fill.

Volume Lash fill $130 - Fill in of volume fan lash extensions to areas of lash fall out on a previously applied Volume set within 2-3 weeks of original full set application. Client must have at least 70% of lash extensions retained to be able to book this service. We do not take new clients for fills, a full set must have been performed by Lush Lash OC within 2-3 weeks of lash fill.

Other:

Required

What is the look you are trying to achieve with lash extensions? *

Longer, fuller, NATURAL looking lashes. I just want to look like I woke up with mascara on.

Longer lashes with a stronger emphasis on fullness for a more dramatic look than my natural lashes. I want to look like I have at least 3-5 coats of mascara on.

Longer lashes with lots of volume and fullness, I want to look Diva Dramatic, like I'm wearing thick false lash strips.

Required

Eye Health History

Do you suffer from any of the following? *

Cataract

Conjunctivitis

Diabetic Retinopathy

Dry Eye Syndrome

Glaucoma

Eye sensitivity (to fumes, lash glue, mascara, pollutants, airborne irritants)

Other:

Required

Covid Health History

In the past 30days have you been sick with any of the following: *

Influenza

Strep Throat/Bronchitis

Pneumonia

Corona Virus

Fever

Dry Cough

Shortness of breathe/breathing difficulties

Vomiting

Do you have severe muscle aches ?

Other:

Required

Please select any of the following if they apply to you: *

Myself or a family member that I am in close contact with has traveled outside of the country in the last 21 days

I have had close contact with or cared for someone diagnosed with COVID-19

I have been diagnosed with or previously had COVID-19

Have you or anyone in your household traveled WITHIN the U.S. in the past 21 days? (Via airports, cruise ship, mass/public transportation)

Option 5

Other:

Temperature Check before service: I’m willing to get my body temperature checked by my lash technician upon her arrival for my lash service. If my Temperature is above 99’ I agree that the lash tech will not proceed with service and will leave the premises. I would need to reschedule the service after 14 days and without having any of the common COVID-19 symptoms including Fever, Cough, Sore throat, Running nose, Respiratory difficulties, Muscle Aches. *

Yes I agree

No - I do not wish to agree and will not continue with booking.

Required

How did you hear about us? * *

Please read the following policies:

Please follow the link to pay for your booking fee in order to hold and confirm your appointment time. You must pay this fee within 24 hours of submitting this questionnaire and a full 48 hours prior to your appointment time.
CANCELLATION POLICY
Please honor your appointment, if you must cancel or reschedule please do so at least 24-
Hours before your appointment time to avoid a cancellation fee. Your booking fee will be held as credit for your future appointment if you are rescheduling within 30 days. If you are canceling with less than 24 hours notice, your booking fee is non-refundable and no credit will be given since staff schedules and service accommodations will have already been made and scheduled out.

SERVICE REFUND POLICY
Because our lash extensions services involve time, supplies, talent, and labor applied, once a lash extensions treatment service has been rendered, Lush Lash OC has a NO REFUNDS/no chargeback policy. If you experience an allergy and are unable to wear the eyelash extensions applied, we will remove them free of charge and may offer a voucher in the form of a gift certificate that can be used to gift to someone else, providing they are in our service area.

CHANGE OF SERVICE FEE
If at the time of your appointment, you decide to change your service to one that is shorter in time or lesser, you will be charged a Change of Service fee of $25. This fee is for the allotted time that is lost that could have been an appointment for another client and/or materials ordered/reserved for your service.

SPACE REQUIREMENT:
Our lash technicians require a well lit open space of about 6x8 in order to fit our lash/massage table, chair, and side table. Please let us know if you will need special accommodations or are bedridden.

Please sign and date to acknowledge your understanding and acceptance of the above policies. (Type out full name and date). *

Thank you for choosing Lush Lash OC for your professional lash extensions. We provide a professional and convenient in-home or on-location spa-like lash extension application experience. You will receive a confirmation email to confirm your appointment time and pay your $50 booking fee. For additional questions, please email us at info@lushlashoc.com or text us at 949-543-0350. Thank you so much! - Lush Lash OC www.lushlashoc.com

Submit

Clear form

Never submit passwords through Google Forms.

This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy

Forms