I have voluntarily elected to undergo this treatment/procedure after the nature and purpose of this treatment has been explained to me, along with the risks and hazards involved, by the massage therapists and estheticians of The Tiny Spa. Although it is impossible to list every potential risk and complication, I have been informed of possible benefits, risks, and complications. I also recognize there are no guaranteed results and that independent results are dependent upon age, skin condition, and lifestyle, and that there is the possibility I may require further treatments of the treated areas to obtain the expected results at an additional cost. I have read and understood the post-treatment home care instructions. I understand how important it is to follow all instructions given to me for post-treatment care.

In the event that I may have additional questions or concerns regarding my treatment or suggested home product/post-treatment care, I will consult the esthetician and massage therapist immediately. I have also, to the best of my knowledge, given an accurate account of my medical history, including all known allergies or prescription drugs or products I am currently ingesting or using topically. I have read and fully understand this agreement and all information detailed above. I understand the procedure and accept the risks. All of my questions have been answered to my satisfaction and I consent to the terms of this agreement. I do not hold the esthetician or massage therapist, whose signature appears below, responsible for any of my conditions that were present, but not disclosed at the time of this skincare procedure, which may be affected by the treatment performed today.

Dermaplaning is a physical exfoliation that removes dead skin cells and vellus hair from the surface of the face.
This form of exfoliation smooths the skin and allows for the active ingredients in skin care products and
treatments to penetrate deeper which increases their efficacy & anti-aging benefits.
Alternatives to dermaplaning include microdermabrasion and scrubs for exfoliation, and waxing, threading or
cream depilatory for hair removal. There is no single treatment to replace dermaplaning.
I understand there are contraindications to this treatment, including but not limited to diabetes, cancer, active
acne, bleeding disorders, and the inability for blood to coagulate following injury. Certain medications
including blood thinners, higher dosages of Aspirin, and Accutane are contraindicated for this treatment due to
increased sensitivity and/or the possibility of delayed clotting from a nick or cut.
I certify that I am not taking any of the above medications or experiencing any of the above conditions.
Alternative treatments such as waxing to remove vellus hair and microdermabrasion for exfoliation, along with
their associated risks, have been explained to me as other options.
I understand this treatment involves the use of a specialized dermaplaning blade to remove dead skin cells and
vellus hair. As with the use of any sharp instrument, there is the possibility of injury. While every precaution is
taken, I understand the risks and consent to receive treatment today.

I agree to have an eyelash lift, brow lamination, and/or eyelash tint applied to my natural eyelashes and/or retouched. By signing this agreement, I consent to the procedure of an eyelash perm, brow lamination, or eyelash tint by my technician.  I understand there are risks associated with having an eyelash perm, brow lamination, and/or eyelash tint. I further understand that as part of the procedure, eye irritation, eye pain, eye itching, discomfort, and in rare cases eye infection or blurriness could occur.  I understand that some mild but normal symptoms may occur with the brow lamination depending on the sensitivity of my skin during the procedure and will subside in 24 hours. These symptoms may include mild tingling, slight redness due to brushing the hairs, slight warmth in the area. I agree that if I experience any of these medical conditions with my lashes that I will contact my technician and consult a physician at my own expense. I understand that even though my technician perms the lashes/brows using the proper technique, the instruments, tapes, cleaners, eye gel pads, adhesives, and removers used may irritate my eyes/brows 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 realize and accept the consequences of failure to adhere to these instructions may cause the eyelashes to not stay permed as long as told. I agree to the following Post- Lash Lift: No water can come in contact with the eye area for 24 hours after the application. Avoid makeup such as mascara, eyeliner, or brow pencil for the first 24 hours. Avoid using oil-containing sunscreens, moisturizers, and cleansers on lashes for the first 24 hours. Acknowledgment 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 my technician. 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 my technician and The Tiny Spa LLC from all liability associated with this procedure, 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.