I understand that if I have any concerns, I will address these with my technician. I give
permission to my technician to preform the lash extension procedure we have discussed,
and will hold him/her harmless and nameless from liability that may result from this
treatment. I understand that my lash technician will take every precaution to minimize or
eliminate negative reactions as much as possible. I agree that this constitutes full
disclosure, and that it supersedes any previous verbal or written disclosures. I certify that I
have read and fully understand, the above paragraphs and that I have had sufficient
opportunity for discussion to have any questions answered. I understand the procedure
and accept the risks. I do not hold the lash technician,
responsible for any of my conditions.