Eyelash Extension Consent

Name*

First NameLast Name

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number*

Please enter a valid phone number.Format: (000) 000-0000.

Do you have any allergies?*

YesNo

Please review each statement carefully and check the box next to each statement.*

I consent to the application, removal, and/or re-touching of the eyelash extensions to the natural lash by the artist below.I understand the risks associated with the application and/or removal of eyelash extensions to the natural lash.I understand that irritation, redness, itching, and watering of the eyes may occur during and/or immediately after the service.I understand and agree that if any of these issues persist, I will contact the artist and may have the eyelash extensions removed.I agree to the aftercare instructions given and realize that the failure to follow these instructions may result in the decreased life of my extensions and/or damage to the natural lash.I consent to having my before and after photos taken for marketing purposes. I understand that these photos may be posted to social media sites.

By signing this form, I am acknowledging and understand the terms of this service as well the information listed above. This agreement will remain in effect for the duration of the service, and any proceeding eyelash extension services in the future conducted with this artist. I consent to this agreement and eyelash extension application/removal services.

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