• Cryo Beauty Queen Lash Lift & Eyelash/Eyebrow Tinting Consent

  •  -  -
    Pick a Date
  •  -
    • I agree to have an eyelash lift (perm) and/or eyelash tint and/or eyebrow tint applied to my natural eyelashes, brows and/or retouched. By signing this agreement, I consent to the procedure of an eyelash perm, eyelash tint or eyebrow tint by Cryo Beauty Queen.
    • I understand there are risks associated with having an eyelash perm and/or eyelash/eyebrow tint. I further understand that as part of the procedure, eye/skin irritation, eye pain, eye itching, discomfort, and in rare cases eye infection or blurriness could occur. I agree that if I experience any of these medical conditions with my lashes/skin that I will contact Cryo Beauty Queen and consult a physician at my own expense.
    • I understand that even though my technician perms the lashes using the proper technique, the instruments, tapes, cleaners, eye gel pads, adhesives, and removers used may irritate my eyes/skin or require a physician’s follow-up care.
    • I understand and agree to the care instructions provided by my technician for the use and care of my permed and/or tinted eyelashes/eyebrows. I realise and accept the consequences of failure to adhere to these instructions may cause the eyelashes to not stay permed as long as told.
    • I confirm I received a patch test 24-48 hours before treatment and had a NEGATIVE reaction 

    I agree to the following Post- Lash Lift/Eyelash Tint/Eyebrow Tint:

    • No water can come in contact with the eye/brow area for 24 hours after the application
    • Avoid using oil containing sunscreens, moisturisers and cleansers on the lashes

    Acknowledgement and Waiver

    I am over 18 years of age and consent to the agreement and to treatment or have a parent with me that consents to this service. This agreement will remain in effect for this procedure and all future procedures conducted by Cryo Beauty queen. I read English and understand that this consent agreement is legal and binding. I have read and fully understand all information in this agreement. I release Cryo Beauty Queen from all liability associated with these treatments, which is performed with the utmost attention to safety and proper application using tools and products that the technician has been professionally trained to use. There are no guarantees for length of time the lashes will stay permed. I understand the aftercare instructions and will do my part to maintain my eyelashes. I understand that there are many factors that may affect the life of the eyelash lift such as water and moisture contact, weather conditions, and activities involving exposure to high temperatures. By signing below, I verify that I have read and understand the above statements and agree to them. 

  • Clear
  • COVID-19 Liability Waiver

  • I acknowledge the contagious nature of the Coronavirus/COVID-19 and that the CDC and many other public health authorities still recommend practicing social distancing.
    I further acknowledge that Cryo Beauty Queen has put in place preventative measures to reduce the spread of the Coronavirus/COVID-19.
    I further acknowledge that Cryo Beauty Queen can not guarantee that I will not become infected with the Coronavirus/Covid-19. I understand that the risk of becoming exposed to and/or infected by the Coronavirus/COVID-19 may result from the actions, omissions, or negligence of myself and others, including, but not limited to, salon staff, and other salon clients and their families.
    I voluntarily seek services provided by Cryo Beauty Queen and acknowledge that I am increasing my risk to exposure to the Coronavirus/COVID-19. I acknowledge that I must comply with all set procedures to reduce the spread while attending my appointment.
    I attest that:
    * I am not experiencing any symptom of illness such as cough, shortness of breath or difficulty breathing, fever, chills, repeated shaking with chills, muscle pain, headache, sore throat, or new loss of taste or smell.
    * I have not traveled internationally within the last 14 days.
    * I have not traveled to a highly impacted area within the US in the last 14 days.
    * I do not believe I have been exposed to someone with a suspected and/or confirmed case of the Coronavirus/COVID-19.
    * I have not been diagnosed with Coronavirus/Covid-19 and not yet cleared as non contagious by state or local public health authorities.
    * I am following all CDC recommended guidelines as much as possible and limiting my exposure to the Coronavirus/COVID-19.
    I hereby release and agree to hold Cryo Beauty Queen harmless from, and waive on behalf of myself, my heirs, and any personal representatives any and all causes of action, claims, demands, damages, costs, expenses and compensation for damage or loss to myself and/or property that may be caused by any act, or failure to act of the salon, or that may otherwise arise in any way in connection with any services received from Cryo Beauty Queen. I understand that this release discharges Cryo Beauty Queen from any liability or claim that I, my heirs, or any personal representatives may have against the salon with respect to any bodily injury, illness, death, medical treatment, or property damage that may arise from, or in connection to, any services received from Cryo Beauty Queen. This liability waiver and release extends to the salon together with all owners, partners, and employees.

  • Clear
  • Should be Empty:
Jotform Logo
Now create your own Jotform - It's free! Create your own Jotform