Please read carefully the following instructions:
Extensions are individual synthetic material that is attached to your own eyelashes, not to your skin.
These lashes can stay up to 4 weeks with proper care and maintenance that depends on the individual, lifestyle, and eyelash growth.
After implementation, please DO NOT:
- try to remove eyelash extensions on your own
- use a regular eyelash curler
- rub your eyes or lashes
- pull your lash extensions
- go to sauna
- use mascara
- cut the extension
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 individual 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 for any unexpected circumstances due to not following these instructions are at my own risk.
I have read the above information. If I have concerns, I will address them with my esthetician, AnaRosa Vasquez at SIMPLY GLOW STUDIO LLC. I give permission to AnaRosa Vasquez at SIMPLY GLOW STUDIO LLC, to perform the eyelash extension procedure we have discussed, and will hold her harmless from any liability that may result from this treatment. I have accurately answered the questions above, including all known allergies, prescription drugs, or products I am currently ingesting or using topically. I understand that SIMPLY GLOW STUDIO LLC will take every precaution to minimize or eliminate negative reactions as much as possible. In the event I may have additional questions or concerns regarding my treatment, I will consult SIMPLY GLOW STUDIO LLC immediately. I agree that this constitutes full disclosure, and that it supersedes any previous verbal or written disclosures. I certify that I have read, and fully understand, the above paragraphs and that I have had sufficient opportunity for discussion to have any questions answered. I understand the procedure and accept the risks. I do not SIMPLY GLOW STUDIO LLC, whose signature appears below, responsible for any of my conditions that were present, but not disclosed at the time of the skin care procedure, which may be affected by the treatment performed today.