Consent, Acknowledgment and Waiver
- I agree to have an eyelash lift and/or eyelash tint applied to my natural eyelashes. By signing this agreement, I consent to the procedure of an eyelash perm and eyelash tint by my technician.
- I understand there are risks associated with having an eyelash perm 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, blurriness or blindness could occur.
- 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 using the proper technique, the instruments, tapes, cleansers, eye pads, adhesives and removers used may irritate my eyes 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. 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 acknowledge the following post lash lift care:
- No water can come in contact with the eye area for 24 hours after the application.
- No makeup such as mascara, eyeliner or brow pencil for the first 24 hours.
- I understand that although lash lift and tints typically last 8-10 weeks, makeup, water exposure and rubbing can effect the longevity of the service.
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. I understand, have read and completed this questionnaire truthfully. I agree that this constitutes full disclosure, and that it supersedes any previous verbal or written disclosures. I understand that withholding information or providing misinformation may result in contraindications and/or irritation to the skin and lashes from treatments received. I am aware that it is my responsibility to inform the esthetician of my current medical or health conditions and to update this history. 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, makeup and touching/rubbing them. By signing below, I verify that I have read and understand the above statements and agree to them.