PATCH TEST FORM Name * First Name Last Name Contact Number Treatment patch tested for: * Lash Lift & Tint Tinting Pro Power Peel Spray Tanning HD BrowSculpt HS Brow Treatment Therapist carrying out Patch Test * Date * MM DD YYYY Please confirm below * I confirm that the above details are correct. I understand I must keep my patch test on my skin for 24 hours before washing it off. If I have any reaction, redness, irritation, itching, stinging or any other undesired effect following my patch test I will notify Heaven Sent and understand that the treatment will not be able to be carried out. I confirm that if there are any changes to my health, skin or anything else that may affect sensitivity to treatment that I will notify Heaven Sent and come for a new patch test. Thank you!