• Lash Lift + Tint / Brown Lamination + Tint & Wax

    Consultation and Consent Form

  • Consultation Form

    Welcome! This form is to let me know more about you and your lash and/or eyebrow goals. Giving full disclosure on the questions below will be the best way for me to be able to treat and handle your lashes and brows with the best care. There's no judgement in my salon, so the more I know about you and your lashes and brows, the better of an experience I can provide to you. Once this form has been submitted, you'll receive either a call and/or text from me within 48 business hours or less. (I am not in the salon on Sundays, Mondays and some Saturdays). I am so excited to meet you, and can't wait to work with you to reach your dream lash and/or brow goals! ~Emilee
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  • Are you 18 years of age or older?*
  • I am interested about receiving the following services: (Check any that apply)
  • Have you ever received any of the below services? (Check all that you have received)*
  • If you have received any of these services before, have you ever had a reaction? If yes, pleased check which services you had a reaction to.*
  • Are you allergic or ever had a reaction to adhesives/glues?*

  • I am informing my technician of any of the following contraindicated conditions for the lash lift and tint, brow lamination, brow wax and/or brow tint services.*

  • I am informing my technician of any of the following contraindicated conditions for the lash lift and tint, brow lamination, brow wax and/or brow tint services.*

  • Have you used any Alpha Hydroxy Acids (AHA) or glycolic products in the past 48-72 hours?*
  • Are you using any other skin thinning products and/or drugs that thin the blood?*
  • I consent to having my eyes closed and covered for the duration of the 45-90 minute lash lift and tint and/or brow lamination procedure(s).*
  • I wear contacts.*
  • How soon are you interested in getting your lash and/or brow service done.*

  • What days and times work best for you to reach your lash and/or brow goals? Select all that apply. If you have a specific dates/time range needed, please indicate that in the "Other" box. If it is not available, we will look at other dates and times that can work.*

  • How did you hear about Curl Up & Dye with Emilee. If a specific person referred you, I would for you to provide their name so that I can thank them. I love and appreciate referrals.*

    • I agree to have an eyelash lift, brow lamination and/or eyelash tint and/or brow wax applied to my natural eyelashes/eyebrows and/or retouched. By signing this agreement, I consent to the procedure of an eyelash perm, brow lamination, brow tint or wax or eyelash tint by my technician. 
    • I understand there are risks associated with having an eyelash perm, brow lamination and/or eyelash tint.
    • I further understand that as part of the procedure, eye irritation, eye pain, eye itching, discomfort, and in rare cases eye infection or blurriness could occur. 
    • I understand that some mild but normal symptoms may occur with the brow lamination depending on the sensitivity of my skin during the procedure and will subside in 24 hours. These symptoms may include: mild tingling, slight redness due to brushing the hairs, slightly warmth in the area.
    • I agree that if I experience any of these medical conditions with my lashes that I will contact my technician and consult a physician at my own expense.
    • I understand that even though my technician perms the lashes/brows using the proper technique, the instruments, tapes, cleaners, eye gel pads, adhesives, and removers used may irritate my eyes/brows or require a physician’s follow-up care.
    • I understand and agree to the care instructions provided by my technician for the use and care of my permed and/or tinted eyelashes/eyebrows. I realize and accept the consequences of failure to adhere to these instructions may cause the eyelashes to not stay permed as long as told.

      I agree to the following Post- Lash Lift:
    • No water can come in contact with the eye area for 24 hours after the application.
    • Avoid makeup such as mascara, eyeliner or brow pencil for the first 24 hours.
    • Avoid using oil containing sunscreens, moisturizers and cleansers on lashes for the first 24 hours.

      Acknowledgement and Waiver I am over 18 years of age and consent to the agreement and to 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. I read English and 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. There are no guarantees for length of time the lashes will stay permed. I understand the aftercare instructions and will do my part to maintain my eyelashes. 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.

    Children's Policy:
    I love your little ones! However, the salon is not always a safe place for children. If your child is not receiving a service, I respectfully ask that you make arrangements for child care (12 years & under). After all, I want this to be a relaxing service for you too. This is a safety issue. I have hot tools, sharp tools, wax, chemicals and breakable things in my studio and I do not want anyone to get hurt. 

    Payments of Services:
    All payments of services must be paid at time of appointment. 
    Venmo and Cash are the accepted methods of payment.
    If you forget your wallet and I have to send you an invoice to pay for your hair services, there will be a $15 service charge for this payment option. All invoices must be paid within a timely manner. Any invoice that is paid after 12 hours of original appointment time will result in a $50 late fee for each day that is not paid. Any services that are not paid by invoice within 24 hours will be considered theft of services and legal action will be taken. Client will be held responsible for all court fees and any other fees that go along with getting paid for the services rendered. 

    Appointment / Cancellation Policies:

    ARRIVAL: Please aim to arrive 5 minutes before your scheduled appointment time. For hair appointments, please have no longer than 2-day unwashed hair. If your hair is generally more oily than dry, please shampoo prior to your color/lightening/keratin service to ensure the treatment will be able to penetrate evenly throughout the hair. For lash and/or brow appointments, please arrive with clean/makeup free eyes, lashes and brows. Extra time spent cleaning your lashes will mean less time lashing. If you arrive after your scheduled appointment time, it may not be possible to extend the time available for your booked service; if your service is shortened due to your late arrival, you will still be charged the full cost of the service. 

    CHANGING YOUR APPOINTMENT: 
    A minimum of 24 hours notice is required to reschedule/cancel a booked appointment without penalty.

    SICKNESS OR FAMILY EMERGENCY: 
    If you or another person in your household, has an infectious or contagious illness, please contact us as soon as possible to reschedule your appointment for a later date. For your safety and that of staff and other clients, please do not come to your appointment sick. If it is assumed you are currently sick, your appointment may be cut short or rescheduled for when you are healthy once again. A one-time allowance of last minute cancellation or reschedule will be permitted for sickness or family emergency. After that, the cancellation and no-show policy is in effect. 

    CANCELLATION + NO-SHOW: 
    As a courtesy, appointment reminders are sent out 72 and 24 hours prior to your appointment either by text, email or both. If an appointment is cancelled or rescheduled within 24 hours of your appointment, you will be charged 50% of your service as a cancellation fee. If you reschedule or no-show your appointment within 4 hours of your scheduled appointment time, you will be charged 100% of your service as a cancellation fee. This is to protect your time that is set aside especially for you, as well as to protect our time which books up quickly. In turn, we promise to keep appointments on time, give you our full and undivided attention and of course, the best hair, lash and brow experience Brentwood, TN & Franklin, TN has to offer!

    AFTER-HOURS APPOINTMENTS: 
    Certain circumstances and seasons may leave you in a panic to squeeze in a last-minute lash or hair appointment that is outside of our normal business hours. After-hours appointments may be available on a case-by-case basis for an additional $50 fee. Please contact us directly to schedule an after-hours appointment.

    REFUND POLICY: 
    You are paying for the stylist’s time, products and other expenses used to provide you with a service. No refunds will be given for any reason on services or products. If you are unhappy with a service, you may contact us within 24-48 hours of your appointment to discuss your concerns and if a change can be done to address your concerns, it will be done so with a complimentary 20-30 minute express touch-up if it is at the fault of the application or product. Any concerns addressed after 24-48 hours of your last appointment or if you failed to follow the proper aftercare instructions, you will be charged at the full price for the service. 

    By signing below, I confirm that all information indicated on this form is true and accurate and I understand the Appointment/Cancellation Policies. I verify that I have read and understand the above statements and agree to them. 

  • Today’s Date*
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