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Eyelash Extension Consent Form
IF Lashes
Name
First Name
Last Name
Date of birth
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Mes
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Día
Año
Fecha
Phone Number
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Area Code
Phone Number
Health History | Please check any of the following that applies to you
Allergy to adhesives band aid or medical tape
Seasonal allergies
Allergy to glycerin
Eye illness or injury
Blepharitis (inflamed eyelids)
Permanent eye-makeup
Drugs that can cause temporary hair loss
Major surgery within last 120 days
Other
Use..
Glasses
Contact Lenses
Have you ever had eyelashes extensions before?
Yes
No
Please agree to the terms and conditions
I accept that eyelash extensions are applied to my natural eyelashes and I give my consent to the placement and/or removal of eyelash extensions by the certified professional.
I understand and agree to the after-care instructions and for any unexpected circumstance that have happened due to not following these instructions are in my own risk.
I understand that in rare occasions there are risks associated with having artificial eyelashes. I further understand that in rare circumstances eye or skin irritation and discomfort may occur.
I understand that because of the natural lash cycle and wear and tear, I will need to maintain my extensions with touch up appointments usually recommended about every 2 to 3 weeks to keep them full.
I understand that during the procedure I’ll have to keep my eyes closed, approximately 60 to 120 minutes.
If I have any pain or itch, I’ll tell the technician
I understand that lash technician can take photos and videos before, during or after the tab application and post it on their social networks.
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Minutes
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PM
AM/PM Option
Client Signature
Lash Tech Signature*
Guardar
Submit
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