HER.VIRGOEYES CLIENT CONSENT FORM

HER.VIRGOEYES EYELASH EXTENSIONS CONSENT FORM
Name *

First NameLast Name
Birth Date
MM/DD/YYYY
Phone Number *
Area Code - Phone Number
Please fill out this form prior to your appointment. This ensures you have fully read, understood, and agreed to all of the following policies and terms.
I am 18 years old or older. If under the age of 18, I have parent guardian permission to receive eyelash extensions, and attend/pay for my lash appointment. *

By checking this box, I understand and accept this statement.I am under the age of 18, by checking this box, I understand and accept this statement.
I hereby agree to have eyelash extensions applied to my natural eyelashes and/or removed and retouched. By signing this agreement, I consent to the placement and/or removal of the eyelash extensions by the certified certified professional. *

by checking this box, I understand and accept this statement.
I understand that in rare occasions there are risks associated with having artificial eyelashes and eyelash extensions applied to or removed from my natural eyelashes. I further understand that in rare cases as part of the procedure, eye irritation and discomfort could occur. I agree that if I experience any of these conditions with my lashes, I will contact the certified professional that performed this procedure and it may beneficial to have the eyelashes removed. *

by checking this box, I understand and accept this statement.
I hereby agree to the after-care instructions provided by the certified professional for the use and care of my eyelash extensions. I realize and accept the consequences of failure to adhere to these instructions may cause the eyelash extensions to fall out and/or decrease the time the lashes will last. *

by checking this box, I understand and accept this statement.
I understand and consent to having my eyes closed and covered for the duration of approximately 60-240 minute procedure until my technician addresses me to open my eyes. Times may vary depending on the type and number of eyelashes applied.*

by checking this box, I understand and accept this statement.
I have not had any COVID symptoms, traveled, or been in contact/exposed to anyone with COVID within the past 14 days. *

by checking this box, I understand and accept this statement.
I hereby agree to the following eyelash extension follow-up and maintenance instructions by following checking the boxes:

No waterproof mascara and oil based products around the eye area.No water can come in contact with the eye area for 24-48 hours after the application.No pulling or rubbing of the eyelash extensions.No strong heat or use of an eyelash curler on the eyelash extensions.
I have viewed and read all the policies and after care in the @her.virgoeyes IG Highlights and agree to all the terms.*

by checking this box, I understand and accept this statement.
I have viewed and read the rescheduling policy. Any rescheduling that is less than a 48 hour notice will automatically require a new deposit to be sent and forfeits the old deposit, with no exceptions. *

by checking this box, I understand and accept this statement.
I have viewed and read the cancellation policy. Appointment cancellations less than a 24 hour notice results in paying for the full service, with no exceptions. *

by checking this box, I understand and accept this statement.
I understand that there are no refunds for any of the services offered, with no exceptions. *

by checking this box, I understand and accept this statement.
This agreement will remain in effect for this procedure and all future follow-ups conducted by the certified eyelash extension professional. I read English and understand that this consent agreement is legal and binding. I have read, fully understood, and agree to all the information in this agreement. I hereby release her.virgoeyes from any claims, demands, and damages of any nature. I acknowledge and agree to paying the full amount of this service in which the service is taken place. I am over 18 years of age and consent to the agreement and to the eyelash extension application procedure provided by her.virgoeyes.
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HER.VIRGOEYES EYELASH EXTENSIONS CONSENT FORM