Eyelash Extension Consent Form
Thank you for choosing Maddis Touch! I’m excited to give you a touch of perfect.🤍
Name
*
First Name
Last Name
Phone Number
*
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Area Code
Phone Number
Email
example@example.com
Health/history| Please check any/all of the following that applies to you
*
Eye illness or injury
Allergy to latex
I wear contacts
I have not had a eyelash extension set before
I wear eye glasses
Sensitive eyes
If you have not had a lash set before, we would you like to have a patch test which we highly recommend? (Note that a patch test does not guarantee that an adverse reaction will never happen)
Yes
No
Please agree to the 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 occasions there are risks associated with having artificial eyelashes. I further understand that in rare circumstances eye or skin irritation and discomfort may occur.
I understand that because of the natural lash cycle, I will need to maintain my extensions with touch up appointments usually recommended about every 2 to 3 weeks to keep them full.
I understand and consent that my eyes will be closed and covers for the duration of 60-120 min. Service. Times vary.
I agree to be recorded, and have my pictures taken and posted on social media.
I agree to all of the policy rules stated on Maddis touch Instagram page.
Date of birth
*
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Month
-
Day
Year
Date
Client Signature
Date
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Month
-
Day
Year
Date
Submit
Should be Empty: