Formulario de consentimiento de extensión de pestañas

Studio High Brow Eyelashes extensions and eyelash lift and tint consent form

Although every precaution will be taken to ensure your safety and wellbeing before, during and after lash service, please be aware of the following information and possible risks.
full name *

Name Last name
Date of Birth ( we have BD coupons)

MonthDayYear
Date
Age *
Cell phone number *

Area CodePhone Number
Email*
example@example.com
Are you under the influence of alcohol or drugs*

YesNo
Is this your first time having Eyelash Extensions or eyelash lift and tint?*

YesNo
Do you wear Contacts? It is suggested to not wear them during the service.*

YesNo
Do you often rub, pull or pick your lashes for any reason?*

YesNo
Do you have , or are you being treated for any eye illness or injury?*

YesNo
Please list any eye drops or eye medication you are currently using
Are you able to lay on your back for 2+ hours to have your lashes applied?*

YesNo
Will you be able to keep your eyes completely closed for up to 2+ hours?*

YesNo
Are you pregnant? ?*

YesNo
What other products do you currently use around your eyes? ( eye creams, oinments, lash growers, etc.
PLEASE NOTE USE OF OIL BASED PRODUCTS AROUND EYES SHOULD BE DISCONTINUED FOR 24 HOURS AFTER YOUR EYELASH EXTENSION SERVICE. It is also recommended to avoid all oil based products around your eyes for as long as you wear your lashes or lift/tint. Oil based products, waterproof mascaras and liners will loosen the adhesive and your lashes will not last long. *
Please initial and date you read and understand the above.
For longevity we recommend not to use mascara ( you're lashes will look so glamorous you won't feel a need to), however if you must, be sure it is oil free and remove it daily with an oil free wash. *
Please initial and date you read and understand the above.
Do you use Lattice? It is best to discontinue the use for 2 weeks before you service and discontinue use while you are wearing your lash extensions or lash lift/tint.*

YesNo
How do you usually sleep? Please note you will lose more eyelash extensions on the side on which you sleep. Sleeping on your stomach will affect them the most and it is important to refrain from sleeping on your stomach for the first 2 days after your service to allow the adhesive to set properly. _*

SideStomachBack
Are you allergic to adhesives ( glues, tapes, band aids, etc)? This service may use adhesives tapes, glues and gel pads thaty may cause an allergic reaction. We use a medical grade, formaldehyde free glue, but allergies may still occur.? _*

YesNo
Have you had Chemotherapy Treatments in the last 6 months? _Medication for chemotherapy may cause a reaction to the materials used in this service. Also, if lashes are just starting to grow back they may be a little weak and we recommend waiting until they are strong enough for this service. _*

YesNo
Have you had Lasik Surgery in the past 4 months? Eyes may have sensitivity to eyelash extensions and products used for prepping the eye area (gel pads, glues, etc.). _*

YesNo
Are you currently taking Thyroid Medications? Thyroid medications or Thyroid Conditions may not last long due to either of these.. _*

YesNo
Blephoroplasty or other eye condition or surgery in the last 6 months? Blephoroplasty , eye surgery or conditions may have sensitivity to eyelash extensions and products used. Consult your doctor first and ask if it's safe for you to have this service... _*

YesNo
Do you have Extremely OIly skin and.or hair? Natural oils will break down the adhesives used to bond the eyelash extensions causing the extensions to fall out quicker. This does not mean you cannot have the service, merely it may cause them to fall out quicker.. _*

YesNo
Beautiful Lashes can put a serious swagger in your step! We use only high quality medical grade glue and soft lightweight lashes to give you a glamorous, yet natural look. Here is what you'll experience today.
Step 1 - Consultation with your Lash Extension Expert to ensure this service is right for you and to explain your before, during, and after experience thoroughly.

Step 2 - Select the style of lashes you would like, to cover length, fullness, and shape. If you're unsure, your lash tech will be happy to recommend what's best for you and your lifestyle.

Step 3 - Get Lashed Up!

Step 4 - Rebook for your refill in approx 2 to 3 weeks.
I understand that eyelash extensions require ongoing maintenance ( similar to a nail service). Refills are recommended approx. every 2 to 3 weeks. I understand if I go beyond this recommended time it may need a full set.*
Initial
I acknowledge and understand that the studio doesn’t do Refunds. The lash tech will Do the best that he or she can to satisfied the customer. *
Initial
I will seek medical care (at my own expense) and contact my technician immediately if any allergic or adverse reaction occurs. All of my questions were answered and I understand the procedure and risks. _*
Initial
I agree and understand that the lash tech has no way of knowing if the client is allergic to some of the products or materials been use in any procedure. *
Initial
I grant permission to use my before and after photos for marketing or examples of my technicians work.*

YesNo
I release my certified lash technician and Hennessy Glam Beauty from any and all liability associated with this procedure. This service will be performed with the utmost attention to safety, sanitation and proper application using tools and products that the technician has been trained and certified to use. This service has many variables due to lifestyle, moisture, weather, extreme tempatures, natural eyelash shedding and other factors. The technician ( along with my consent form and consultation) will decided if I am a good candidate for this serive to the best of their ability.*
Initial
By signing below, I verify that I have read and understand the above statemetns and agree to them. Thank you for the time you took to read, understand and agree to our consent form..
Sign date *

MonthDayYear
Date
Client signature *
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Studio High Brow Eyelashes extensions and eyelash lift and tint consent form

Beautiful Lashes can put a serious swagger in your step! We use only high quality medical grade glue and soft lightweight lashes to give you a glamorous, yet natural look. Here is what you'll experience today.