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KILLER BEAUTY BY KATRINA <br />CLIENT INFORMATION SHEET <br />NAME <br />DOB <br />ADDRESS <br />PHONE <br />May we contact you at this number if necessary? <br />Eyebrow Procedure(s) Desired: Microblading Ombre <br />Powder Combo Hybrid <br />How did you hear about my service? Instagram <br />Facebook Referred <br />Family/Friend who referred <br />you: <br />Are you currently under the care of a physician? Yes <br />No <br />If Yes, why? <br />Physician's <br />Name: <br />Do you take antibiotics prior to surgery or dental procedures? <br />Yes No <br />If Yes, why? <br />Do you suffer from: <br />Allergies to latex <br />Antibiotics Hepatitis <br />Moles/Freckles at tattoo site <br />Allergic reactions to <br />Heart problems or <br />