Consent Form

Consent Form

Jewels Lash
Name*

First NameLast Name
Phone Number

Area codePhone Number
Email*
Health History - Please check any of the following that applies to you*

Allergy to adhesives band aid or medical tapeAllergy to surgical glue or nail glueEye illness, recent surgery or injuryBlepharitis (inflamed eyelids)I confirm that I am NOT presenting any of the following Covid-19 symptoms - Cough,Fever,Sore Throat & Runny nose.
Have you ever had eyelashes extensions before?*

YesNo
TERMS AND CONDITIONS *

I hereby agree to have eyelash extensions applied to my natural lashes and consent to the placement and/or removal of the eyelash extensions by the certified professional.I understand and agree to the after-care instructions and for any unexpected circumstance that have happened due to not following these instructions are in my own risk.I understand that in rare circumstances eye or skin irritation and discomfort may occur.I understand that I will need to maintain my extensions with touch up appointments usually recommended about every 2 to 3 weeks to keep them full.
Signature*
Date

MonthDayYear
By signing this consent form, I, hereby acknowledge and agree to the terms and conditions above
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