Full Name
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First name
Last name
Phone Number
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Format: (000) 000-0000.
Email
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example@example.com
I grant permission to Luxury Lashes by Alex to use my before and after photos for marketing or examples of my technicians work. *We will make you look fabulous!*
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Yes
No
I release Luxury Lashes by Alex 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 the studio does NOT offer refunds. Luxury Lashes by Alex will do their ultimate BEST to provide a service experience to meet your satisfaction and expectations to LOVE your lashes every appointment. I have a 72 hour grace period for a complimentary fix if any premature fallout happens, you must contact me within 72 hours from your appointment for any corrections to be made. Anything after that, you would need to book a mini lash fill.
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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. I also agree to be on time to my appointment and acknowledge being later than 15 minutes will result in needing to book for another day and also a payment of 50% of the service will be required if that occur. Being late=less lashes being applied and cannot promise 100% coverage/removal of old outgrown lashes.
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Initial
Cancelations made after the 24 hour period of scheduled appointment (same day cancellation) will require 50% payment of the scheduled appointment . No call no shows are 100% charge. (Letting me know 10 min before appointment is considered a no show.) I agree to these terms.
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Initial
Is this your first time having Eye-lash Extensions or lash lift/tint?
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Yes
No
Do you often rub, pull or pick your lashes for any reason?
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Yes
No
How do you usually sleep? Please note, you will lose more eyelash extensions on the side on which you sleep.
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Side
Stomach
Back
Are you able to lay on your back for over an hour to have your lashes applied?
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Yes
No
I understand that cash or Zelle is the preferred payment but if a credit/debit card is needed for payment I understand there will be a $5 fee included to the service cost.
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Please initial you read and understand the above.
Are you over the age of 18? If not, a legal parent/guardian must grant permission and sign the form for you.
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Yes
No
The following conditions are not suitable for eyelash extensions. Possible adverse reactions are listed below each condition
Are you currently taking Thyroid Medications? Thyroid medications or Thyroid conditions may not have lash extensions last long due to either of these
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Yes
No
Do you have any known allergies to adhesives, latex, or other eye-related products?
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Yes
No
I agree and understand that Luxury Lashes by Alex have 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. 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
For the safety and security of both clients and my business, I do require a valid photo ID to be uploaded with your intake form. This helps me verify your identity and ensure a secure booking process.By submitting your ID, you acknowledge that this information is for identity verification purposes only and will be kept confidential in accordance with my privacy policy.
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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.
Upload photo ID here
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I'm Ready Girl! XOXO
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