*Eyelash extensions require medical tape and adhesives that may contain acrylic or latex.

Client Medical History

*Check all that apply

I ACKNOWLEDGE THE FOLLOWING STATEMENTS: I understand that eyelash extensions are semi-permanent; lasting effects are highly variable and are dependent upon the skill and expertise of the lash technician, my normal hair growth cycle, use of cosmetics and skin care products, and adherence to the instructions for maintenance and care. I have been given the opportunity to ask questions about the products, application procedure, and any risks involved. The above information is truthful to the best of my knowledge. I do not have any known conditions, allergies, or unusual sensitivities in my eye area or have listed them above. I understand touch-up appointments may be necessary for an additional cost. I hereby authorize Lash Technician Kyra Ellis-Cairns to perform lash extension application on me at my request. In the unforeseeable event of an allergic reaction, Kyra Ellis-Cairns of Keyluxe Beauty and Ink – 3007 Clairemont Drive #S03 San Diego, California 92117 will not be held responsible under any circumstance. All services are non-refundable.

Cancellation Policy

Keyluxe Beauty and Ink has a 24-hour cancellation policy. Your deposit will be refunded back to you if you cancel before the 24-hour window. Your deposit will be transferred in the event of a reschedule. For late cancels or no-shows, 100% of the cost of the service is charged to the card on file. See Policies > Cancellations for more details.

Waiver of Consent & Liability

By signing the Waiver of Consent & Liability form, you are agreeing to the following:

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1. I understand the natural lash cycle and normal wear/tear will require in-fill maintenance of my extensions, if desired.

2. I understand lash extensions are not a permanent service. Semi-permanent lash extensions and their lasting effects are highly variable and typically require bi-weekly fills to remain full.

3. I am 18-years or older, or my parent/legal guardian has agreed to this Waiver of Consent & Liability.

4. I understand the aftercare instructions provided to me in my booking e-mail and can reference back to anytime at under the Forms tab.

5. I understand to keep my eyes closed throughout the application process as tearing can cause the lashes to bond together rather than be isolated one-by-one.

6. I understand all risks come with lash extensions as some materials used throughout the application process can cause allergic reactions and sharp implements are being used around the eyes and facial areas. (Allergic reactions can develop at anytime due to the adhesive, adhesive removal solutions, eye patches, or medical tape - even if you've had extensions before.) 

7. I hereby release any and all persons representing Keyluxe Beauty and Ink from all claims, demands, damages, actions and cause of action arising out of performance of services requested.

8. I give consent for photographs to be taken of my eyes and their natural lashes and/or lash extensions.

9. I understand it is my responsibility to ask any questions regarding services I have requested and I have been given the opportunity to ask any questions about the products, application procedure, and any risks involved. 

10. In the unforeseeable event of an allergic reaction, Keyluxe Beauty and Ink will not be held responsible under any circumstance.

Aftercare & Maintenance

I agree to follow the care and maintenance instructions provided by the eyelash extension artist for the use and care of my eyelash extensions, and that if any follow up care is required due to my own mistake or negligence, or failure to follow these instructions, this will be at my own expense and risk. I understand that if I do any of the following, it may result in damage to my eyelash extensions or may cause my lashes to fall off prematurely. Knowing this I agree to follow these tips for best results:

• I understand that I should not attempt to remove my lash extensions on my own or with any product, but that the procedure requires that my eyelash extensions be professionally removed.
• I understand not wet eyelashes for the first 24 hours.
• I understand to avoid saunas, steam rooms, jacuzzis, hot yoga, and swimming within the first 48 hours.
• I understand to avoid pulling, picking, and twisting lash extensions. This can cause damage to your natural lashes and may lead to premature shedding of your lashes.
• I will use a bare mascara wand that has been provided to me to brush my extensions every morning, night, and as needed to reduce tangling and flipping extensions.
• I understand to avoid daily use of mascara but if applied, only use water-soluble mascara.
• I understand is it recommended to NOT use water-proof mascara.
• I understand curling of lash extensions is not recommended as it may shorten the lifespan of the extensions.
• I understand to avoid oil-based facial cleansers, products, and eye makeup removers that contain solvent-like ingredients such as glycols and carbonates as they can reduce the wear time of your new lashes.
• I understand to cleanse lashes of makeup and debris daily. I will consider using recommended lash products!
• I will contact my lash artist for my bi-weekly to monthly touch-ups or when I notice about 50% of my lashes have shed or grown out.