Eyelash and eyebrow services Consent Form (only fill this out once a year)
Luxe Lash Co
Full Name
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First name
Last name
Cell Phone Number
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Format: (000) 000-0000.
Email
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example@example.com
How did you hear about Luxe Lash Co?
Please let us know who referred you as we have amazing referral bonuses for you and them!
I am aware Luxe Lash Co will use my before and after photos for marketing or examples of my artists work. *(typically only the eyes for photos) please let us know if you’re ok with that-we have an awesome photo wall and great airbrush makeup settings !
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Ok
I release Luxe Lash Co from any and all liability associated with this(these) procedure(s). 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 & licensed 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 doesn’t offer refunds. Luxe Lash Co will do their ultimate BEST to provide a service experience to meet your satisfaction and expectations to LOVE your lash or brow services at your appointment. Please report any excess fall out (if at all) or issues within the first 24h and we will do the best to make adjustments.
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Initial
Eyelash extensions require on-going maintenance (similar to a nail service). Refills are recommended approximately every 2 to 3weeks dependant on your care and lash cycle growth. I understand if I go beyond this recommended time it may result to an incur (higher) service cost as a full-set(or ULTRA FILL IN). I will make sure to have atleast 40-50% of my lashes for my fill in appointment (OR A FULL SET MUST BE BOOKED! Please note : WE OFFER foreign fill ins as a flat fee of $150 —but keep in mind if your lashes are not applied properly it could result in a removal and new full set which MAY not be achievable in the same day - - if your lashes from another artist are neat clean and manageable we will charge the regular fill in rate (this is at the artists discretion)***
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Initial
I acknowledge Luxe Lash Co does their full effort to fulfill my appointments times and I respectfully acknowledge the times I schedule to be available. All appointments must be confirmed (a text and email is sent 2 days prior to confirm) If the appointment is not confirmed 24h before the appointment date - it will be CANCELLED. The no show/ 48H (2 day ) CANCELLATION policies are also non-refundable agreements of service. If you cancel or reschedule after 48hrs before your appointment, a 50% fee of the service will be accessed. If you fail to pay the cancellation fee this fee + a 50% deposit will be required upon next booking.. If you cancel often you will no longer able to book with Luxe Lash Co. No Call no shows and SAME DAY CANCELLATIONS will be charged a $75 flat fee. While things may happen we do understand but please respect our time and policies. Please try to be on time. We advise appropriate booking.
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Are you able to lay on your back for 2 or so hours to have your lashes applied?
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Yes
No
Please come to your appointment with no eye- makeup. For an eyebrow service please come with a clean face & eyebrows as well. Any eye makeup will require a deep clean fee for $25 if it’s caked all over the lash line and requires a deep scrub.
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Please initial you read and understand the above.
I agree and understand that my Lash professional has 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. Luxe Lash Co DOES offer patch tests to those that are not sure if they are a good candidate and will help to discuss options. 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. Please note if you do not get a patch test and do have an allergic reaction - the service is non refundable. We will remove the lashes free of charge if they are able to be removed.
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Initial
Blepharoplasty or other eye condition or surgery in the last 6 months? Blepharoplasty, eye surgery or conditions may have sensitivity to eye-lash extensions and products used. Consult your doctor first and ask if it's safe for you to have this service
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Yes
No
Have you had Lasik Surgery in the past 4 months? Eyes may have sensitivity to eyelash extensions and products used for prepping the eye area. (gel pads, glues, etc.)
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Yes
No
Thank you giving us the time to get to know YOU & signing the Consent form, its much appreciated towards your lash experience!
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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.
Sign date
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Month
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Day
Year
Date
Client signature
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Signature of Parent or Guardian if under the age of 18
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