Keratin Lash Lift Client Liability Form

Appointment Date*

Date

Name*

First NameLast Name

Email*

example@example.com

Phone Number*

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How did you hear about us?*

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If you were referred, please state their name:

Lash Lift & Tint Agreement (please check to agree):*

I understand that the lashes will be curled with an advanced solution and a conditioning cream.I understand that as part of the procedure eye irritation, pain, itching discomfort and in extreme rare cases, eye infection may occur.I understand failure to follow the aftercare instructions may cause an undesirable result.I understand that in order to have the Keratin Lash Lift service, I will need to keep my eyes closed for duration up to 60 minutes during the procedure. I also understand that I will need to be lying in a reclined position. Any medical conditions that might be aggravated by lying still for a prolonged period of time may mean that I will not be able to have the procedure performed on my eyes.I understand that opening my eyes at any point during the Keratin Lash Lift procedure is not recommended, and may cause an undesirable result. I agree to keep my eyes closed throughout the procedure unless instructed to open them by my technician.I release Transform Beaute, LLC from all liability associated with this procedure. There are no guarantees for how long the lash lift will last, on average it last between 6-8 weeks. Transform Beaute, LLC is not responsible for any technician errors. I understand that I have been advised to follow the aftercare protocol from my technician so as to avoid any discomfort or adverse side effects after the procedure has been completed.This agreement will remain in effect for this procedure and all future Keratin Lash Lift procedures conducted by Transform Beaute, LLC. I understand that this agreement is binding and that I have read and fully understand all information above. I represent that I am over the age of 18 years.

Optional Photography Consent:*

I hereby grant Transform Beaute, LLC the full right to take, publish and reproduce photographs of me, my face, my eyes and/or eyelashes, both before and after this procedure, for any advertising, education, or other purposes whatsoever, including the right to retouch these photographs as deemed necessary. I further expressly assign any copyright in these photographs for any advertising or other purposes, along with any comments I may provide.No, please do not use my photos

Signature*