Consent form

New Clients:
Know You better

Please complete intake & consent form prior to first appointment. Your answers are kept strictly confidential.
I understand that there are risks associated with having artificial eyelashes applied to and/or removed from my natural lashes.

I understand that the eyelash extensions will be applied to the natural lash as determined by the technician so as not to create excessive weight on the natural eyelash thereby preserving the health, growth and natural look of the client's natural eyelashes.

I understand that as part of the procedure eye irritation, pain, itching discomfort and in rare cases eye infection may occur.

I understand and agree that if I experience any of these issues with my lashes I will contact my technician and have the eyelash extensions removed immediately and consult a physician at my own expense.

I understand that even though the technician may apply and remove the eyelash extensions properly, that adhesive material may become dislodged during or after the procedure, which may irritate my eyes or require further follow up care.

I understand and agree to follow the aftercare instructions provided by my technician. Failure to follow the aftercare instructions may cause the eyelash extensions to fall out.

I understand that in order to have the eyelash extensions applied to my eyelashes I will need to keep my eyes closed for duration of ~~ 60-180 minutes during the procedure.I also understand that I will need to be lying in a reclined position. Any medical conditions that might be aggravated by lying still for a prolonged period of time may mean that I will not be able to have the procedure performed on my eyes.

This agreement will remain in effect for this procedure and all future procedures conducted by my technician or any other technician the salon/spa listed below. I understand that this agreement is binding and that I have read and fully understand all information above. I represent that I am over the age of 18 years. If below 18 years of age a parent or guardian must also sign this form.

I release my technician or salon/spa from all liability associated with this procedure. There are no guarantees for the bonding time length of the eyelash extensions. Our company or salon is not responsible for any technician errors.

I understand that I have been advised to follow the aftercare protocol from my technician so as to avoid any discomfort or adverse Side effects after the procedure has been completed.

I understand that If I have any concerns, I will address these with my lash extension specialist. I give permission to my lash extension procedure we have discussed, and will hold him/her and his/her staff harmless and nameless fromany liability that may reslt from this treatment.I have accurately answered the questions above, including all Known allergies, prescription drugs, or products I am currently ingesting or using topically.

I understand my lash extension specialist will take every precaution to minimize or eliminate negative reactions as much as possible. In the event I may have additional questions or concerns regarding my treatment, I will consult the lash extension specialist immediately.I agree that this constitutes full disclosure,and that it supersedes any previous verbal or written disclosures.

I certify that I have read, and fully understand, the above paragraphs and that I have had sufficient opportunity for discussions to have any questions answered. I understand the procedure and accept the risks. I do not hold the lash extension Specialist, whose signature appears below, responsible for any of my conditions that were present, but not disclosed at the time of this procedure, which may be affected by the treatment performed today.