Eye Lash Extensions Intake & Consent Form
Full Name
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First name
Last name
Instagram (optional)
Cell Phone Number
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Format: (000) 000-0000.
I grant permission to Gabriela Maldonado [ Vida Bella Lashes ] to use my before and after photos for marketing or examples of my technicians work.
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Yes
No
I release Gabriela Maldonado [ Vida Bella Lashes ] from any and all liability, claims, damages and demands that may result to injury and loss associated with this procedure. I will hold Gabriela Maldonado harmless and nameless from any liability that may result from this treatment. 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
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Initial
Have you ever had lash extensions before?
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Yes
No
I acknowledge and understand that the studio doesn’t offer refunds. If I have issues with my lash extensions (premature shedding, want to change styles etc) I have 72 hours to contact Vida Bella lashes to fix the issue or remove the extensions free of charge.
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Initial
I acknowledge Vida Bella Lashes does their full effort to fulfill my appointments times and I respectfully acknowledge the times I schedule to be available. I understand the following set CANCELLATION policies that are also non-refundable agreements of service. If I cancel or reschedule 24 hrs before my appointment I will forfeit my $20 deposit.
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It is also recommended to avoid all oil-based products around your eyes for as long as you wear your lashes. Oil based products, waterproof mascaras and liners will loosen the adhesive and your lashes will not last long. Please arrive to your appointment with out eye makeup or contacts. I understand that a $15 deep cleaning fee will be issued if I arrive with dirty lashes.
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Please initial you read and understand the above.
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.
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Please initial you read and understand the above.
I acknowledge Gabriela Maldonado [ Vida Bella Lashes] advised me to remove contacts before my appointment and therefore not responsible for repercussions if I did not remove them
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Yes
No
I agree to have Gabriela Maldonado (Vida Bella Lashes) to apply eyelash extensions to my natural lashes. I understand I am purchasing the extensions and demonstrating the products being used. I consent to placement and removal by the lash technician.
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Initial
I agree that if I experience any medical conditions with this procedure, I will contact the lash technician to have the extensions removed immediately and consult a physician to my own expense.
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Initial
This agreement will remain in effect for this procedure and all future procedures conducted by Gabriela Maldonado (Vida Bella Lashes) I read English and understand this consent agreement is legal and binding. I have read and understand all of the information in this agreement.
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Initial
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By signing below, I verify that I have read and understand the above statements and agree to them.
Sign date
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Client signature
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SUBMIT
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