Lashedj Consent Form

Lashedj Consent Form

Lash and Brow studio
Client Information
Name*

First NameLast Name
Age*
Date of Birth*

MonthDayYear
Date
Email*
example@example.com
Phone Number*

Area CodePhone Number
Address*

Street Address

City Province

Postal Code
Emergency Contact Details

**only fill out if you are under the age of 18**
If you are a minor, in case of emergency, we will contact the person below:
Emergency Contact Name

First NameLast Name
Phone Number

Area CodePhone Number
Relationship
Signature of parent or guardian if under the age of 18

Clear
Please sign here
Previous lash experience
Are you using any of the following

AccutaneRetinols/retinoidsFace exfoliantsEye dropsContacts
What service are you booking for?*

Lash Lift and TintLash ExtensionsBrow Lamination
Do you have any allergies to Latex? *
If yes, please specify on the field above.
Do you have any allergies to banana's, kiwi's, strawberries, polish remover, nail polish, or Nuts?*
If yes, please specify on the field above.
Do you usually rub, pull, or pick your lashes?*
If yes, please specify on the field above.
Have you ever had previous irritations to lash extensions? *
If yes, please specify on the field above.
Reason for switching Lash artists?
If you feel comfortable sharing.
Any concerns you have regarding Lash extensions and/or Lash lift and tints I should be aware of?*
If yes, please specify on the field above.
HOW DID YOU HEAR ABOUT US?*

Instagram.FacebookFriendOther
Consent and Waiver
I certify that I have read this entire informed consent and I understand and agree to the information provided in the form. My questions regarding lashes have been answered. I hereby release Lashedj and Jocelyn Meersseman from all liabilities associated with lash extensions and/or Lift and tint/brow laminations.I give permission to Lashedj to use any photos taken for instagram and/or promotional events.I acknowledge that all information I provided in this form is true and accurate.I acknowledge that I am coming to this appointment at my own risk. Lashedj is taking all necessary precautions regarding COVID-19 sanitary stipulations and will not be held liable for any COVID-19 related illness's .I have read through Lashedj's Policy page on the website and understand all the policies to the best of your abilities.
Lash Technician doing your service

Jocelyn MeerssemanAshley Wain
Signature of the Client*

Clear
Please sign here
Date Signed*

MonthDayYear
Date
Should be Empty:

Lashedj Consent Form

Client Information

Emergency Contact Details

Previous lash experience

Consent and Waiver