New Client Waiver
Name
*
First Name
Last Name
I Understand the importance of disclosing my health history before my appointment and will not withhold any prior or current conditions
*
Yes
No
I Understand that synthetic eyelash extensions will be adhered to my natural eyelashes during this service
*
Yes
No
I understand that my technician can only apply extensions that are safe for your natural lashes to prevent damage
*
Yes
No
I Understand that I am required to lie still with my eyes closed for an extended period of time and that opening my eyes prematurely can expose them to fumes which may irritate or cause a reaction
*
Yes
No
I understand the risks that may be associated with this service which includes redness, irritation, allergic reaction or possible blindness
*
Yes
No
I understand that my natural lashes will grow and fall out and that fill appointments are required every 2-3 weeks to maintain the eyelash extensions
*
Yes
No
I understand that should an allergic reaction occur, a refund will not be issued but I can request a free professional removal
*
Yes
No
I Understand that Halie Rocha Lashes does not offer any refunds and that all sales are final
Yes
No
I understand that proper aftercare must be followed to keep my extensions clean and healthy, I will follow all aftercare rules given to me after my appointment
*
Yes
No
I understand and agree that by signing this waiver I release Halie Rocha from any expenses, liabilities and damages that may come from this or any future procedures or purchases
*
Yes
No
I agree that I am 18 years or older (please show photo ID upon arrival to your appointment)
Yes
Signature
*
Date
*
-
Month
-
Day
Year
Date
Submit
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