CLIENT PROFILE FICHE CLIENT ENΔ IDENTITYFirst nameNameAddressCityPostal codeCountrySelect countryAfghanistanAland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelauBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Saint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBritish Virgin IslandsBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicDemocratic Republic of the Congo (Kinshasa)DenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyIvory CoastJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacao S.A.R., ChinaMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalestinian TerritoryPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRepublic of the Congo (Brazzaville)ReunionRomaniaRussiaRwandaSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint Martin (Dutch part)Saint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia/Sandwich IslandsSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited Kingdom (UK)United States (US)United States (US) Minor Outlying IslandsUnited States (US) Virgin IslandsUruguayUzbekistanVanuatuVaticanVenezuelaVietnamWallis and FutunaWestern SaharaYemenZambiaZimbabweMobile numberPhone numberEmail addressOffice postal codeProfessionDate of birthTREATMENTIn which Atelier du Regard will you be having your treatment? Genève Rhône Genève Cornavin Lausanne Sion FribourgWhat treatment are you here for ? Eyelash extensions Lash Lift Brow Lift Semi permanent mascara Plasma Lift Eye contour care Eyebrow epilation Tinting Eyeliner - Between eyelashes Semi-permanent eyebrow make-up Semi-permanent lips make-upCONSENTCondition for the achievement YesDate :**I accept the treatment conditions. For semi-permanent or permanent make-up services, I have read, understood and accept the conditions of treatment contained in the health questionnaire and in the Consent and Release form - Atelier du Regard - Atelier des LèvresPrivacy policyTo find out more about our data protection policy, click here: https://atelierduregard.ch/politique-de-confidentialite/ ou https://atelierdeslevres.ch/politique-de-confidentialite/PHOTOI hereby authorize the professionals at Atelier du Regard SARL and/or ADR Development SA to take photos of my face, eyes, eyelashes or lips and to publish them for training, promotional or other purposes, including the right to retouch these photos if necessary. Furthermore, I agree to give these photos free of charge. Yes NoLOYALTY PROGRAMI want to participate in the loyalty program and receive a permanent discount on all my future services. I authorize the sending of emails and exclusive offers to my email address (if you accept, you will receive your loyalty card to save on the email address provided). Yes NoChoosing a reference institute Genève Rhône Genève Cornavin Lausanne Sion FribourgPrécédentSuivantPROGRAMME DE FIDÉLITÉÀ remplir par l'EyeDesigner ou la LipsDesignerCatégorie de la cliente : STARLETTE 1 à 300 points STAR 301 à 900 points SUPER STAR 901 à 1600 points DIVA à partir de 1601 pointsDate de validité Précédent FINALISER
