Although every precaution will be taken to ensure your safety and well being before, during and after your lash extension application, please be aware of the following information and possible risks.

I understand that a full set of lash extensions can make the appearance of my own lashes about 30-50% thicker, and make my lashes appear 20-50% longer.

I understand that lash extension services have some inherent risk of irritation to theorbital eye area, including the eye itself and could result in stinging, burning, blurry vision and potential blindness should the adhesive enter the eye or should an allergic reaction occur.

I understand that some irritation, itching or burning may occur on the skin if the bonding agent comes into contact with it.

I understand that if the bonding agent comes into contact with my eye, my eye will be flushed with water and I will be assisted in seeking medical attention immediately.

I understand that this is a semi-permanent procedure, as my natural lashes will continue to grow and fall out normally, making touch-up or "fill" appointments necessary to maintain the original look achieved by replacing the lashes that have fallen out.

I understand that while every attempt will be made to provide me with the length and fullness I have chosen, my final result may not be what I initially envisioned.

I understand that it is imperative that I disclose all of the information requested in the Client Intake Form.

I have cited all conditions and circumstances regarding my health history, medications being taken, and any past reactions to products or medications.

I understand that additional conditions could occur or be discovered during the procedure which could affect my ability to tolerate the procedure.

I consent to "before and after" photographs for the purpose of documentation, potential advertising and promotional purposes.

I understand and consent to having my eyes closed throughout the procedure.

I understand that if I have any concerns, I will address these with my Lash Extension Specialist at The Luxury Lash Studio.

 

I am informing the Lash Extension Specialist at The Luxury Lash Studio of the following conditions verbally which will be notated in my chart by the Lash Extension Specialist at The Luxury Lash Studio 

Current use of contact lenses which I may be asked to remove during the procedure.

Current use of anything such as oil-containing sunscreen or moisturizers around the eyes.

Current use of eye drops of any kind, prescription or over-the-counter.

Current allergies or sensitivities.

History of recurrent eye or tear duct infections.

History of dry eyes or Sjorgen's Syndrome.

Recent history of Chemotherapy.

Other medical conditions which would prohibit or compromise placement and retention of eyelash extensions.

No waterproof mascara.

No oil based products around the eye area.

No water can come in contact with the eye area for 24 hours after the application.

No tinting or perming of eyelash extensions.

No pulling or rubbing of the eyelash extensions.

Should any kind of eye drops be necessary extra care should be taken to prevent moisture from coming into contact with the eyelash extensions.

This agreement will remain in effect for this procedure and all future follow-ups conducted by the Eyelash Extension Specialist at The Luxury Lash Studio.

I understand my Lash Extension Specialist at The Luxury Lash Studio will take every precaution to minimize or eliminate negative reactions as much as possible.

I will hold The Lash Extension Specialist and The Luxury Lash Studio harmless and nameless from any liability that may result from this treatment.

I certify that I have read and fully understand, the above paragraphs and that I have had sufficient opportunity for discussion to have any questions answered.

I understand the procedure and accept the risks. I do not hold the Lash Extension Specialist at The Luxury Lash Studio, whose signature appears below, responsible for any of my conditions that were present but not disclosed at the time of this procedure which may be affected by the treatment performed today.

I have read and fully understand all information in this agreement. I am over 18 years of age and consent to the agreement and to the eyelash extension application procedure.