• Lash Lift and Tinting Services

    Consultation & Consent Form
  • Date of Birth*
     / /
    2 digit month, 2 digit day, 4 digit year
  •  -
  • Contact Preference*

  • Referred by:

  • Client Health History

  • Have you ever had your lashes permed?*
  • Have you ever had your hair temporarily dyed?*
  • Have you ever had a reaction to adhesive tape, hair dye, fumes or eye remover?*

  • If you answered "Yes" to any of the following, please explain:

  • Please list all current medications you are taking (including over-the-counter herbs, vitamins and supplements):

  • Please list any allergies you have (including cosmetics/ingredients):

  • Do you currently have, or ever had, any of these conditions?*

  • Any other health conditions not listed:

  • Are you currently pregnant or nursing?*
  • Have you had any recent tattoos done around your eye area?*
  • Have you ever had Botox, Juvederm or any other injectables?*
  • How fast do you feel your hair grows?*

  • Is there anything else we should know?

  • Pre & Post Treatment Care Guide

  • During the lash lift procedure, your natural lashes are curled using a chemical semi-perm solution, similiar to getting your hair permed at a hair salon. Tinting your lashes and/or brows are a great addition for a temporary darkening effect. After initial application, the chemical solutions involved needs time to settle. So although lash lifts and tints require little to no homecare, the first 24-48 hours are crucial to increase the longevity of your lashes.

    Before your appointment: 

    • Avoid using mascara 2-3 days before your first appointment. The film it leaves on your lashes blocks solutions from working correctly.
    • Arrive to your appointment with dry, make-up free, clean lashes/brows.
    • Remove contact lenses before your appointment. Your contacts may not initially react well to the perming solution.
    • Do not drink caffine as it causes eye twitching and restlessness. Sleeping during your service is welcomed and highly encouraged.

    During the inital 24 hours after your appointment: Do not get your lashes wet for 24 hours after the lash lift and/or tint procedure as it will affect the chemical solution of the perm and dye. 

    • Avoid wearing makeup.
    • Avoid steam from showers, facials, saunas and swimming pools.
    • Avoid using oil products on your lashes and around your eye area.
    • If redness or irritation occurs apply a cool damp cotton compress to the eye area. If symptoms presist even after 24 hours, seek medical attention.

    General guidelines to extend the life of your lash lift and/or tint

    • Be gentle with your lashes. Avoid rubbing your eyes or pulling your lashes.
    • You may continue to wear makeup, even mascara. However, stay away from "waterproof" mascara and eyelash curlers!
    • Apply castor oil when your lashes start to feel dried out or look spidery.

  • Informed Consent

    Although every precaution will be taken to ensure your safety and well-being before, during, and after your lash lift and/or tint application, please be aware of the following information and possible risks. Please Initial:

  • Acknowledge & Waiver

    I am over 18 years of age and consent to the agreement and treatment, or have a parent with me that consents to this service.

  • This agreement will remain in effect for this procedure and all future procedures conducted by my technician, Jessica Mae Tagalicud. I understand that this consent agreement is legal and binding. I have read and fully understand all information in this agreement. I release my technician from all liability associated with this procedure, which is performed with the utmost attention to safety and proper application, using tools and products that the technician has been professionally trained to use. I understand the aftercare instructions and accept responsibility in the consequences of failing to do so. I understand that there are many factors that may affect the life of the eyelash lift such as water and moisture contact, weather conditions, and activities involving exposure to high temperatures. Therefore, I understand the length of time of the lash lift and/or (brow) tint results are not guaranteed. 

    By signing below, I verify that I have read and understand the above statements and agree to them.

  • Date
     - -
    2 digit month, 2 digit day, 4 digit year
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