Eyelash Extensions Consent Form
Lash Technician Taina Arguedas -Insta: T_lashedme
Full Name
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First name
Last name
Cell Phone Number
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Format: (000) 000-0000.
Instagram Handle or Email
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example@example.com or @example_213
I grant permission to T_lashedme(Taina Arguedas) to use my before and after photos for marketing or examples of my technicians work. *I will make you look GREAT!*
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Yes
No
I release T_lashedme(Taina Arguedas) 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 temperatures, natural eyelash shedding and other factors. The technician (along with my consent form and consultation) will decide if I am a good candidate for this service to the best of their ability.
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Initial
I acknowledge and understand that T_lashedme(Taina Arguedas) does not offer refunds and will do their ultimate BEST to provide a service experience to meet your satisfaction and expectations to LOVE your lashes every appointment.
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Initial
I acknowledge T_lashedme(Taina Arguedas) does their full effort to fulfill my appointments times and I will be available under my own appointment made. I understand the following set CANCELLATION policy. If you cancel or reschedule less than or 24 hrs before your appointment, your $20 deposit will not be refunded. If you cancel often you will be no longer able to book. While things may happen, I advise appropriately booking. LATE policy: After 10-15mins $10 will be added to your service, after 20mins you have chose to cancel your apt, T_lashedme(Taina Arguedas) will hold onto deposit.
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Initial
Eyelash extensions require on-going maintenance (similar to a nail service). Refills are recommended approximately every 2 to 3 weeks. I understand if I go beyond this recommended time it may result to an incur (higher) service cost as a full-set.
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Initial
Is this your first time having Eye-lash Extensions?
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Yes (I'm EXCITED!)
No (I do this all the time!)
Do you wear Contacts? If YES, please do not come to appointment with them in, the glue can dry out your contacts badly leaving you with very red and irritated eyes.
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Yes
No
Do you have a severe eye illness or are you being treated for an eye injury? Received LASIK eye surgery in the past 4 months or received CHEMOTHERAPY in the last 6 months?
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Yes
No
Are you able to lay on your back for 3-4.5 hours to have your lashes applied?
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Yes
No
Are you pregnant? If YES, after 25 weeks it is not recommended to lay on your back for more than 1hr so I would be unable to service you properly or safely, so I highly advise waiting until after pregnancy.
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Yes
No
It is also recommended to avoid all oil-based products around your eyes for as long as you wear your lashes. Oil based products, waterproof mascaras and liners will loosen the adhesive and your lashes will not last long. Please come to your appointments with CLEAN EYES, NO MAKEUP! **Additional $5 will be applied to service if lash tech has to remove makeup debris or dirt for you**
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Please initial you read and understand the above.
Are you allergic to adhesives (glues, tapes, band aids, etc)? This service may use adhesives tapes, glues and gel pads that may cause an allergic reaction. I use a medical grade glue, but allergies may still occur.
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Yes
No
I agree and understand that T_lashedme(Taina Arguedas), my Lash Technician, has no way of knowing if the client is allergic to some of the products or materials being used in any eye-lash procedure, though we do use sensitive eye products to ensure comfort every client is different. T_lashedme(Taina Arguedas) does offer patch tests to those that are not sure if they are a good candidate and will help to discuss options. 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.
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Initial
Thank you for giving me the time to get to know YOU & signing the Consent form, its much appreciated towards your lash experience! Due to COVID restrictions you are REQUIRED to wear a mask the entire duration of the lash service. Unfortunately this also means NO GUESTS, sorry for any inconvenience.
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By signing below, I verify that I have read and understand the above statements and agree to have answered medical questions honestly to my knowledge. As well as you fully understand and respect COVID restrictions and guest policy. If you cannot follow COVID guidelines or guest policy I will turn you away day of or during the service and your deposit will NOT be refunded.
Sign date
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Month
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Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Client signature
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I'm Ready! See Ya Soon 💓
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