Eyelash extension consent form

Date of Appointment *

Date

Name*

First NameLast Name

Phone Number*

Area CodePhone Number

Emergency contact name*

Emergency contact phone number*

Health/Allergy information

Please list any allergies you have (including cosmetics/ingredients) type N/A if none *

YesNo

YesNoI don't know

I would like a patch test (make sure you make the appt 48 hours before your full set appt) Your full set appt is not a patch test.I do not want a patch test

YesNo

YesNoOther

Do you have any questions/concerns or have anything you think we should know?

Consent

Type a question

Although every precaution will be taken to ensure your safety and well being before, during and after your lash extension application, please be aware of the following information and possible risks. By selecting I agree to the terms you are agreeing to the following: * I understand that due to the time and products used, services are non-refundable. If I have concerns with my results, I agree to contact Knockout Beauty Bar within 24–48 hours so the service can be reviewed. I agree not to dispute the charge for services received. *I understand that a full set of lash extensions can make the appearance of my own lashes about 30-50% thicker, and make my lashes appear 20-50% longer. *I understand that lash extension services have some inherent risk of irritation to the orbital eye area, including the eye itself, and could result in stinging and burning, blurry vision and potential blindness should the adhesive enter the eye or should an allergic reaction occur. *I understand that some irritation, itching or burning may occur on the skin if the bonding agent comes into contact with it. *I understand that if the bonding agent comes into contact with my eye, my eye will be flushed with water and I will be assisted in seeking medical attention immediately. *I understand that this is a semi-permanent procedure, as my natural lashes will continue to grow and fall out naturally (as they would without extensions), making touch-up or “fill” appointments necessary to maintain the original look achieved by replacing the lashes that have fallen out due to its natural cycle. Most clients require a fill appointment every 2-3weeks. 4 weeks is the longest in between fills appts- anything after that is a full set appt at a full set price. *I understand that while every attempt will be made to provide me with the length and fullness I have chosen, my final result may not be what I initially envisioned. *I understand thaClient Profile/Health History. *I have cited all conditions and circumstances regarding my health history, medications being taken, and any past reactions to products or medications. *I understand that additional conditions could occur or be discovered during the procedure whichcould affect my ability to tolerate the procedure. *I consent to “before and after” photographs for the purpose of documentation, potential advertisingand promotional purposes etc. *I understand that if I have any concerns, I will address these with my lash extension specialist. *I give permission to my lash extension specialist to perform the lash extension procedure we have discussed,and will hold him/her and his/her staff harmless and nameless from any liability that may result from thistreatment. *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 discussion to have any questions answered. *I understand theprocedure and accept the risks. I do not hold the lash extension specialist, or business, responsible for any of my conditions that were present, but not disclosed at the time of thisprocedure, which may be affected by the treatment performed today.*

I agree to these terms

YesNo

Signature*

During your full set and fill appts Please keep movements to a minimal, no chewing gum, no talking with your hands, body should be as still as possible, no swaying feet back and forth, keep facial expressions as calm as possible etc. Lashing any type of movement can cause disruption in your service and we won’t be able to get you as full and the extensions may not grab your natural lash correctly making them fall off prematurely.

What to do to prepare for your appt?

Bring headphones/book on tape- get ready to nap

Remove contact lenses if you have any

Do not drink coffee 3 hours prior to your appt

Go to the bathroom prior.

This will be a 2 hour appt- if you cannot sit still the lash process will not only take longer but not guaranteed to look it’s best

After care is so important! You must keep your lashes clean.

**Purchase our favorite lash cleanser for $20 to keep those lashes free of oil, sweat, pollen, debris etc!**

*Do not get your lashes wet for 24 hours after your full set & fills

*No oil Products near or on your eyes!

*Be aware of what you spray on your face/hair as it will land on lashes and make them fall off!

*Brush lashes with a spoolie when they get "tangled" do not brush too hard

*wash lashes a couple times a week with the appropriate cleanser.

**lash fills should be booked in advance every 2-3 weeks. If over 4 weeks it is considered a full set and the price will reflect a full set.**

WHAT IS THE DIFFERENCE BETWEEN TYPES OF LASHES?!

𝒞𝓁𝒶𝓈𝓈𝒾𝒸 ℒ𝒶𝓈𝒽𝑒𝓈 are one extension placed on one natural lash.

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𝒱𝑜𝓁𝓊𝓂𝑒 ℒ𝒶𝓈𝒽𝑒𝓈 are 3-6 lighter extensions made into a fan, on one natural lash- giving you a much fluffier/fuller look.

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ℋ𝓎𝒷𝓇𝒾𝒹 ℒ𝒶𝓈𝒽𝑒𝓈 are a combination of classic and volume.

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ℳ𝑒𝑔𝒶 𝒱𝑜𝓁𝓊𝓂𝑒 is 7-16 lighter extensions made into a fan on each natural lash giving you a very dark/fluffy/full look

Other things that also can affect your retention are:

•Medication

•Birth control

•vitamins

• Spray that you spray on your hair/face

•Touching your lashes and getting your natural oils on them from your fingers

•Sleeping on your face

•Face products

•Eye products- our skin around the eye is like tissue paper, even if you don’t apply it to your lashes it can soak up. be mindful of how close you are putting your eye cream.

•Makeup

•Makeup remover- this is usually one of the bigger reasons! Use a lash foam cleanser, it does the job and cleans your lashes safely.

•Not cleansing after a workout

•Some clients need a fill every 2 weeks vs every 3 weeks.

No children allowed. If you come with a child your appt will be canceled & paid in full without a refund.