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CONTOURS BEAUTY INK — Lash & Brow Services | Client Intake. Please complete this form before your service. Your provider will review your answers and confirm the services appropriate for you.

1 | SERVICES REQUESTED
2 | HEALTH & ALLERGY SCREENING — Check any that apply now or in your history; explain below. Check “None of the above” only if no items apply.

I have answered accurately to the best of my knowledge. I will report changes before each visit. Disclosure does not automatically mean I cannot receive a service; my provider may modify or postpone it or request medical guidance.

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