Eyelash Extension Consent and Policies Form

Wake Up Beauty Eyelash Extension Consent and Policies Form

Thank you for choosing Wake Up Beauty
Name

First NameLast Name
Phone Number

Area CodePhone Number
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Have you ever had eyelashes extensions before?

YesNo
If no, would you like to have a patch test which we highly recommend? (Note that a patch test does not guarantee that an adverse reaction will never happen)

YesNo
If you do not have a patch test you need to agree that you take full responsibility for any outcome. As we know they are not very reliable when testing for reactions for lash extensions and even when having a pact test it does not guarantee that you will not have a reaction. You agree this information has been shared with you and that you contest to the treatment without a patch test.
Agree

YesNo
Health History | Please check any of the following that applies to you

Allergy to adhesives band aid or medical tapeAllergy to surgical glue or nail glueSeasonal allergiesPregnancyBack injury or severe painEye illness or injuryBlepharitis (inflamed eyelids)Glasses or contactsDrugs that can cause temporary hair lossMajor surgery within last 120 daysTested possitive of Covid since last patch testOther
Do you have any eye sensitivity that you are aware of or have reacted slightly to in the past? Extra measures can be made during your treatment to make it more confutable.
Please agree to the terms and conditions

I hereby agree to have eyelash extensions applied to my natural lashes and consent to the placement and/or removal of the eyelash extensions by the certified professional.I understand and agree to the after-care instructions and for any unexpected circumstance that have happened due to not following these instructions are in my own risk.I understand that in rare occasions there are risks associated with having artificial eyelashes. I further understand that in rare circumstances eye or skin irritation and discomfort may occur.I understand that because of the natural lash cycle and wear and tear, I will need to maintain my extensions with touch up appointments usually recommended about every 2 to 3 weeks to keep them full.
Covid 19 - Due to covid 19 extra measures are made before and during your treatment to follow government guidelines. Please read and agree to the below measures before treatment. You can contact Sarah to discuss anything below or on this form at any time. You or a member of your household does not currently have covid 19 or ANY symptoms You or a member of your household have not been instructed to isolate Your or a member of your household have not been out of the country in the last 10 days. You agree to wear a face covering during treatment if possible. You agree to come to your appointment alone (unless with another client) to minimise foot traffic in the lash environment. You will turn up to your appointment on time as there is no “Waiting Area” You agree to inform Naomi if you or a member of your household tests positive within 7 days of your appointment. If you have had covid 19 since your last set of lashes you have a higher chance of having a reaction to the treatment and should opt in for a patch test.
Agree

YesNo
Deposit, Late Cancelation, and No Show policy.

A Deposit of $25 will be required within 24 hours of booking your appointment will not be secured until the payment has been received and confirmed.

Deposits are non refundable.

If you hve to rebook, your deposit can be transferred before 24 hours before your appointment date & time.

Naomi has a relaxed cancelation policy and understands that sometimes life can get in the way of our plans, it is asked that if possible please give 24 hours to cancel/amended your appointment.

If 24 hour notice is not given, you will be charged a fee of half the service.

No-Show Fee is 100% of service if there is No Call/No show

Please come with lashes clean and free of makeup.

When having a treatment done you pay for the service provided, time and products used. In the rare event there is an issue refunds will not be given but a repeat appointment will be made as soon as possible.
Agree

YesNo
Do you agree to have pictures/video taken during or after this treatment and allow them to be shared on socila media

YesNo
Date

MonthDayYear
Date
Client Signature

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Wake Up Beauty Eyelash Extension Consent and Policies Form