• LASH EXTENSION CLIENT CONSENT FORM

    • I UNDERSTAND THAT THERE ARE RISKS ASSOCIATED WITH HAVING ARTIFICIAL EYELASHES APPLIED TO AND/OR REMOVED FROM MY NATURAL LASHES
    • I UNDERSTAND THAT AS PART OF THE PROCEDURE, EYE IRRITATION, PAIN, ITCHING DISCOMFORT AND IN RARE CASES EYE INFECTION MAY OCCUR.
    • I UNDERSTAND THAT IN ANY CASE OF ALLERGIES OR REACTION IS NOT LIABLE ON THE TECHNITION AND SERVICE WILL NOT BE REFUNDABLE.
    • I UNDERSTAND IN THE CASE OF RETENTION ISSUES WITHIN THE FIRST 24-48 HOURS I WILL REPORT IT TO MY TECHNICIAN AND UNDERSTAND THAT AN APPOINTMENT WILL NEED TO BE SET UP TO FILL LASHES. A FEE MAY APPLY AFTER DETERMINING THE CAUSE. NO REFUNDS.
    • I UNDERSTAND AND AGREE THAT IF I EXPERIENCE ANY OF THESE ISSUES WITH MY LASHES I WILL CONTACT MY TECHNICIAN AND HAVE THE EYELASH EXTENSIONS REMOVED IMMEDIATELY AND CONSULT A PHYSICIAN AT MY OWN EXPENSE.
    • I UNDERSTAND THAT EVEN THOUGH THE TECHNICIAN MAY APPLY AND REMOVE THE EYELASH EXTENSIONS PROPERLY, THAT ADHESIVE MATERIAL MAY BECOME DISLODGED DURING OR AFTER THE PROCEDURE, WHICH MAY IRRITATE MY EYES OR REQUIRE FURTHER FOLLOW UP CARE.
    • I UNDERSTAND AND AGREE TO FOLLOW THE AFTERCARE INSTRUCTIONS PROVIDED BY MY TECHNICIAN. FAILURE TO FOLLOW THE AFTERCARE INSTRUCTIONS MAY CAUSE THE EYELASH EXTENSIONS TO FALL OUT.
    • I UNDERSTAND THAT IN ORDER TO HAVE THE EYELASH EXTENSIONS APPLIED TO MY EYELASHES I WILL NEED TO KEEP MY EYES CLOSED FOR DURATION OF 60-180 MINUTES DURING THE PROCEDURE.
    • THIS AGREEMENT WILL REMAIN IN EFFECT FOR THIS PROCEDURE AND ALL FUTURE PROCEDURES CONDUCTED BY MY TECHNICIAN.
    • I UNDERSTAND THAT THIS AGREEMENT IS BINDING AND THAT I HAVE READ AND FULLY UNDERSTAND ALL INFORMATION ABOVE.
    • I RELEASE MY TECHNICIAN, Rosa, AND Radiance By Rosa LLC FROM ALL LIABILITY ASSOSIATED WITH THIS PROCEDURE. THERE ARE NO GUARANTEES FOR THE BONDING TIME LENGTH OF THE EYELASH EXTENSIONS.

  • BY PRINTING YOUR NAME BELOW, I VERIFY THAT I HAVE READ AND UNDERSTAND THE ABOVE STATEMENTS AND AGREE TO THEM. 

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