Eyelash Extension Consent & Waiver of Liability

Eyelash Extension Consent & Waiver of Liability
Although every precaution will be taken to ensure your safety and wellbeing before, during and after your lash extension application, please be aware of the following information and possible risks.
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Date
Have you ever had eyelash extensions before?
If no, we recommend a patch test. Please initial if you are opting out of the advised adhesive patch test.
Please initial that you understand that a patch test does not guarantee that a adverse reaction will not happen.
Do you have or had any of the following ?

Allergic to Adhesives (glues, tapes, band aids, etc.)Chemotherapy Treatments within the last 6 months?Thyroid/ Hormones MedicationsLasik Surgery less than 4 months (must wait 4 weeks post-op exam for medical consent)Blepharoplasty (must wait 6 months post-op for medical consent)Any other allergies, allergic reactions, or medical conditions.
Please type any allergies or medical conditions here and add anything else you may seem appropriate that could effect having eyelash extensions.
CLIENT WAIVER & RELEASE

Please read each statement and acknowledge by checking each box by doing so you have READ, UNDERSTOOD and AGREE to the TERMS.
I understand there are risks associated with having artifical eyelashes applied to and/or removed from my existing eyelashes, and that not withstanding the utmost of care in the application or removal of these products, there still risks associated with the procedure and product itself, which include, without limiation, eye irritation, eye pain, discomfort, and in rare cases, blindness even when applied in the usual manner.
As part of the removal procedure, I understand that a certain amount of chemical adhesive remover is applied to exsiting adhesives and a reaction occurs to dissolve the adhesive that results in thinning of the remover. Even though the eyelash extension artist may apply or remove my eyelash extensions in the usual manner, I understand the liquid remover may seep into my eyes, which may irritate my eyes or require further follow up care, at my own expense to prevent damage to my eyes.
The agreement will remain in effect for this procedure and all future follow ups conducted by the certified eyelash extension professional. I read English and understand that this consent agreement is legal and binding. I have read and fully understand all information in this agreement and hereby release any and all persons representing this company from all claims, demands, damages, actions and cause of action arising out of ther performance of the service. I have fully disclosed all condtions regarding my health history, medications and past reactions to products, treatments and medications. I am over 18 years of age and consent to the agreement and to the eyelash extension application procedure.
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Eyelash Extension Consent & Waiver of Liability

CLIENT WAIVER & RELEASE