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The artists.
The services.
Client registration.
The policies.
Workshops.
Contact us.
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The artists.
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Hands + Feet
Lashes + Brows
Body Sugaring + Waxing
Facials + Cosmetic Treatments
Back
LASHES + BROWS
BODY SUGARING + SKIN CARE
HANDS + FEET + GEL NAILS
Body Contouring Intake + Registration
Back
THE BABE CAVE
THE LASH ROOM
Because COVID-19
Privacy
Back
Classic Lash Extensions
Lash Lift Workshop
Home
What's poppin'.
The artists.
The artists.
The services.
Hands + Feet
Lashes + Brows
Body Sugaring + Waxing
Facials + Cosmetic Treatments
Client registration.
LASHES + BROWS
BODY SUGARING + SKIN CARE
HANDS + FEET + GEL NAILS
Body Contouring Intake + Registration
The policies.
THE BABE CAVE
THE LASH ROOM
Because COVID-19
Privacy
Workshops.
Classic Lash Extensions
Lash Lift Workshop
Contact us.
Subscribe.
Book now
CLIENT REGISTRATION : HANDS | FEET | GEL NAILS
PERSONAL CONTACT INFO
*
First Name
Last Name
Date of Birth
*
MM
DD
YYYY
Address
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Phone
*
(###)
###
####
Email
*
Would you like to be added to our mailing list re: news, updates + special offers?
*
No
Yes
MEDICAL HISTORY
Are you pregnant or breastfeeding?
*
No
Yes
Do you have any known allergies or sensitivities?
*
Check all that apply.
Latex
Nail adhesives
Acrylates
Topical creams/ointments
Seasonal allergies
I don't have any known allergies or sensitivities.
Do you have any other medical conditions we should know about?
*
(Thyroid, diabetes, arthritis, etc.)
No
Yes
If so, please provide details.
Have you had any recent surgeries?
*
No
Yes
If so, please provide details.
Have you had any recent skin treatments?
(Laser, chemical peels, body treatment, etc.)
No
Yes
If so, please provide details.
Do you have any skin conditions?
*
(Eczema, warts, etc.)
No
Yes
If so, please provide details.
Are you taking any medication or supplements?
*
No
Yes
If so, please provide details.
Do you use any skin care products that contain Retinol, Retin-A/AHA or other skin thinning ingredients?
*
No
Yes
If so, please provide details.
REFERRAL
How did you hear about us?
*
Social media (IG/FB)
Google search
Family or friend
Other
Please provide details.
If you chose "other", please explain. If you were referred by someone, please provide their full name - we'd love to extend our gratitude!
CONSENT
Waiver
*
I agree to follow the care and maintenance instructions provided by my nail technician/esthetician. I understand that if I do not follow any or all of the care instructions, it may result in damage to my manicure/pedicure/gel nails. I understand that any follow up care due to my own mistake or negligence, or failure to follow care instructions will be at my own expense and risk. I understand that the application of gel nails is not a permanent procedure, as my natural nails will continue to grow, making fill appointments necessary to maintain them every 2-3 weeks. I understand that what I want may not be identical to pictures I may have seen, as the amount, length and thickness of my natural nails will determine the length of nails I can achieve. I agree that by reading and signing this consent, I release THE BABE CAVE and/or THE LASH ROOM from any claims or damages of any nature. I understand that I have requested and agreed to have a manicure, pedicure and/or gel nail service at THE LASH ROOM and/or THE BABE CAVE, and a trained professional will perform the service(s) to it's highest standard.
I AGREE
I DISAGREE
Permission to use pictures
*
I consent to "Before + After" pictures for the purpose of documentation, advertising, promotional and educational purposes.
I AGREE
I DISAGREE
Your Signature
*
I authorize the trained and certified professional(s) of THE BABE CAVE and/or THE LASH ROOM at 155 Provencher Blvd, Winnipeg, Manitoba to perform my requested manicure, pedicure and/or gel nail services. A thorough explanation of the procedure, care and maintenance, and any procedural complications will be discussed with me. I will also be provided with and agree to follow aftercare instructions. By filling in your name below (your electronic signature), you verify that you have read, understand and agree to the above terms.
First Name
Last Name
Date
*
MM
DD
YYYY
APPOINTMENT DETAILS
Service(s) requested.
*
Please check all that apply.
Manicure
Pedicure
Toecure
Gel Polish/Shellac
Lil' Babe Mani + Pedi
LCN Gel Nails - new set
LCN Gel Nails - overlays
LCN Gel Nails - fill
Gel nail or gel polish removal
Which of our service providers did you book your appointment with?
*
Terra
Janis | THE LASH ROOM
COVID-19 SCREENING
This is a preliminary screening to confirm your appointment. You will need to use the Shared Health MB online COVID-19 screening tool on the day of your appointment prior to coming in. We have provided a direct link to it in the footer of our website.
Do you or anyone you have been in contact with have any of the following symptoms: severe difficulty breathing (e.g., struggling for each breath, speaking in single words), chest pain, confusion, extreme drowsiness or loss of consciousness?
*
No
Yes
Do you have shortness of breath at rest or difficulty breathing when lying down?
No
Yes
Do you have a new onset of any of the following symptoms: fever/chills, cough, sore throat/hoarse voice, shortness of breath, loss of taste or smell, vomiting, or diarrhea for more than 24 hours?
*
No
Yes
Have you been in contact in the last 14 days with someone that is confirmed to have COVID-19?
*
No
Yes
Have you been in a setting in the last 14 days that has been identified by public health as a risk for acquiring COVID-19, such as on a flight, in a workplace with a cluster of cases, or at an event?
*
No
Yes
Have you travelled outside of Manitoba in the last 14 days, excluding personal travel to border communities?
*
No
Yes
Do you have a chronic health condition that you are concerned about?
*
No
Yes
Do you have a new onset of 2 or more of any of the following symptoms: runny nose, muscle aches, fatigue, conjunctivitis (pink eye), headache, skin rash of unknown cause or nausea or loss of appetite?
*
No
Yes
If your answer was 'yes' to any of the above, please contact Health Links-Info Santé in Winnipeg at 204-788-8200; toll free elsewhere in Manitoba 1-888-315-9257, and cancel your appointment. *
You may reschedule your appointment on the advice of Health Links and/or your family doctor. By checking the box below, you verify that you have completed the COVID-19 screening questionnaire in its entirety and in truth.
I HAVE READ + COMPLETED THE COVID-19 SCREENING QUESTIONS ABOVE IN ITS ENTIRETY + IN TRUTH.
Thank you!
