Eyelash Extension

  • Client Information

  • Today’s Date
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  • Do you wear contacts ?
  • Do you have frequent eye irritation, itching, or watery eyes?

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

  • Are you allergic to cyanoacrylate
  • Are you allergic to acrylic?
  • During the process would you prefer

  • PLEASE CHECK ANY OF THE FOLLOWING THAT MAY APPLY TO YOU:

  • RELATING TO THE EYE
  • GENERALLY RELATING TO EYELASHES

  • Cancellation & No Refund Policy

    Your appointment time is reserved just for you. I require a $45 NON REFUNDABLE DEPOSIT FEE TO BOOK ANY FULL SET ( It does go towards your service ). I also require a 24 HOUR NOTICE for any cancellations or changes to your appointment. There is a 5 MINUTE GRACE period given for all appointments sceduled, anything after 5 minutes is a 10$ charge added. After 10 minutes your appointment needs to be rescheduled. If you NO CALL NO SHOW you will not be able to book any service in the future with me. I DO NOT GIVE ANY REFUNDS. I am investing my time and products.These policies are NON- NEGOTIABLE and have been set in place for your protection and the protection of me. 

  • Waiver of Liability

    I have read and completed the Eyelash Extension Intake Form in its entirety and in truth. I acknowledge that I have been advised of the potential harmful or negative side effects (such as the possibility of being allergic to glue) I understand that the procedure requires that I lay still for up to 2 hours or longer with my eyes shut, and that if I wear contacts, I must remove my contact lenses for the duration of the lash extension application or removal. I further state that I wil not hold the lash extension specialist Mariah Bernal responsible for any conditions that were present, but not disclosed at the time of this procedure, which may be affected by the treatment performed today. 

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