• Eyelash Extension Consent Form

    Eyelash Extension Consent Form

  • Format: (000) 000-0000.
  • Health History | Please check any of the following:
  • Have you had eyelash extension before?
  • Please read carefully the following instructions:

    Eyelash Extensions are individual synthetic material that are attached to your own eyelashes, not to your skin.

    These lashes can stay up to 2 months with proper care and maintenance that is dependent on the individuals lifestyle and eyelash growth cycle. Typical clients need to come in for fills every 2-3 weeks. 

    After application, please DO NOT:

    • try to remove eyelash extensions on your own
    • use an eyelash curler
    • rub your eyes or lashes
    • pull your lash extensions
    • use saunas
    • use mascara
    • cut the extensions

    By signing this appointment and consent form, I, hereby, acknowledge, consent, and agree to all of the following:

    • I have read and understood the instructions above.
    • The eyelash extension procedure requires synthetic eyelashes to be glued to my own natural eyelashes.
    • It is my responsibility to keep my eyes closed and be still during the entire procedure until the technician leads me to do the opposite.
    • There are some risks of this procedure may be but not limited to eye redness and irritation. The fumes from the adhesive may cause my eyes to tear up if I do not keep my eyes closed.
    • I disclosed any allergies that I may have.
    • I need to follow the after-care instructions and any unexpected circumstances due to not following these instructions are at my own risk.

    I confirm and agree that I wish to engage eyelash extension services at Peony House Beauty of my own will.

  • Date
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