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Patch Test Record

Long Lashes
This form will be completed at your initial consultation by your therapist. You should ensure that you do not get the area tested wet for 24 hours and let your therapist know if there are any signs of reaction such as redness, itchiness, swelling. Although rare, more serious reactions can occur, such as breathlessness, dizziness, extreme pain or swelling, in which case you should seek IMMEDIATE medical attention.

Client Contact Details

Date test administered

Date and time
:

Details of products tested

Declaration

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