• Eyelash Extension Consent Form

    SOLEIL&CO
  • Date of Birth*
     / /
    2 digit month, 2 digit day, 4 digit year
  • Is this the first time you’ve had eyelash extensions applied?*
  • Have you worn any of the following lashes in the last 10 days?
  • Have you gotten a lash lift in the last 30 days?
  • Do you wear contact lenses or glasses?
  • Do you suffer with Trichotillomania?
  • Do you habitually pull and pick out your lashes?
  • Do you agree to lay down for the full amount of application time (up to 2.5 hours)?
  • Please check any of the following that apply to you;
  • Do you understand that any of the above can contribute to retention issues or premature fallout of natural lashes?
  • I agree to have eyelash extensions applied to my natural lashes. Before my qualifies service provider performs this service, I agree to complete this form truthfully and accept all aftercare requirements to protect my investment. Initials*
  • Waiver of Liability - I understand the potential risks involved with getting professionally applied eyelash extensions. I understand that even with expert application and proper aftercare, there are risks involved with this service such as minor eye pain, discomfort, potential for allergic reactions and irritations. Initials*
  • Permission to use my photographs - I grant my full permission to take, publish and retouch any photographs of my eyes, eyelashes and face before and after my lash extension service for the purpose of advertising and creating educational material. I also grant permission to retouch any photographs of myself if deemed necessary by my service provider. Initials*
  • If you use my photos, please;
  • Aftercare - I agree to accept all aftercare requirements provided below. I understand that eyelash extensions require meticulous care. I understand that it is not recommended to ever remove my eyelash extensions at home. If I neglect to take care of my eyelash extensions it will be at my own risk and expense. Initials*
  • No known Medical Conditions (Informed Consent) - I have read and agreed to this intake form in it's entirety and I have been properly advised of the potential harm or side effects that may be caused by a specific medical condition listed above. I understand that the professional eyelash adhesive, remover or chemicals used on me during the service can potentially irritate the skin, eye or follicles. I understand that in very rare cases, I could be allergic to cyanoacrylate, solvents, tapes or synthetics that are present in lash adhesive. Initials*
  • Aftercare Requirements*

  • Aftercare Requirements

    • No picking or pulling your eyelashes

    • Avoid sleeping on one side of your face- use a silk pillowcase to avoid pulling

    • Wash your lashes everyday with an eyelash extension approved cleanser

    • No eyelash curlers

    • No mascara overtop of your eyelash extensions 

    • Avoid saunas, working out, pool chemicals or extreme heat 24 hours after application

  • If for some reason you are suffering poor retention, an irritation or have an issue with your eyelash extensions please contact me directly to resolve this issue immediately.

  • I agree to have read and accepted all of my service provider's policies including but not limited to no shows, rescheduling and cancellation and late fees. In the event of an emergency I will notify my service provider that I am unable to make my appointment time within 24 hours to avoid any fees. Initials*

  • I agree that this form is binding upon myself, my legal representatives and my assigns. I am over the age of 18, and with my signature below I consent to this service

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