Lash Dusk Consultation Form

I DO NOT HOLD THE LASH SPECIALIST, MIA MARSALLO, RESPONSIBLE FOR ANY OF MY CONDITIONS THAT WERE PRESENT, BUT NOT DISLOSED AT THE TIME OF THIS PROCEDURE, WHICH MAY BE AFFECTED BY THE TREATMENT PERFORMED.

AGREEMENT

PLEASE READ & AGREE TO ALL TERMS AND CONDITIONS. THANK YOU!

I agree to have a lash lift or eyelash extensions applied to my natural eyelashes and/or removed and retouched. By signing this agreement, I consent to the placement and/or removal of the eyelash extensions by the certified eyelash extension professional.

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

I understand that in rare occasions there are risks associated with having artificial eyelashes and eyelash extensions applied to or removed from my natural eyelashes, as well having a lash lift performed. I understand that lash extension and lash lift services have some inherent risk of irritation to the orbital eye area, including the eye itself and could result in stinging and burning, blurry visions and potential blindness should the adhesive or lifting creams enter the eye or should an allergic reaction occur. I agree that if I experience any of these conditions with my lashes that I will contact the certified eyelash professional that performed this procedure and it may be beneficial to have the artificial eyelashes removed.

I understand and agree to the after-care instructions provided by the certified eyelash extension professional for use and care of my eyelash extension/lash lift. I realize and except the consequences of failure to adhere to these instructions may cause the eyelash extensions to fall out and/or decrease the time the lashes/lash lift will last.

I understand and consent to having my eyes closed and covered for the duration of approximately 120+ minute procedure. Regarding lash extensions, times may vary depending on the type and number of eyelashes applied.

I agree to the following EYELASH EXTENSIONS follow-up and maintenance instructions:

-No mascara

-No oil-based products around the eye area

-No water can come in contact with the eye area for 24hrs after the applications

-No tinting or perming of eyelash extensions

-No pulling or rubbing of the eyelash extensions

PLEASE schedule touch-ups every 2-3 weeks. Going any longer than 3 weeks without a fill WILL result in higher pricing.

 

I agree to the following LASH LIFT follow-up and maintenance instructions:

-No mascara for 24/48hrs

-No oil-based products around the eye area for 24/48hrs

-No water can come in contact with the eye area for 24hrs after the application

-Avoid sleeping on your sides/face for 24/48hrs following the procedure

-No pulling or rubbing of the natural lashes.

-Use proper aftercare for best results

PLEASE schedule touch-ups every 6-8 weeks

 

I understand that if I have any concerns, I will address these with my lash extension specialist. I give permission to my lash extension specialist to perform the lash extension/lash lift procedure we have discussed and will hold him/her and his/her staff harmless and nameless from any liability that may result from this treatment. I have accurately signed to all of the statements above and the questions above. I understand my lash extension/lash lift specialist will take every precaution to minimize or eliminate negative reactions as much as possible. In the event that I may  have additional questions or concerns regarding my treatment, I will consult the lash extension/ lash lift specialist immediately. I agree that this constitutes full disclosure, and that it supersedes any previous verbal or written disclosures. 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/ lash lift specialist, who 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 understand that there is a strict NO REFUND policy following this procedure.

 

 

POLICY AGREEMENT

I agree to the following policies:

- CANCELLATION POLICY: I agree to pay 50% of my original service fee upon failure to give a 24 hour notice of cancellation to my lash artist.

- NO SHOW POLICY: I understand that if I do not show up to my appointment with no prior notice to my lash artist, it will consequence in the ability to further book appointments. I agree to pay 50% of the service to my lash artist.

- LATE ARRIVAL POLICY: I understand that my lash artist can only guarantee the remaining time of the service. For example, if I show up 10 minutes late to my 60 minute appointment, 50 minutes of service time remains.

- PAYMENT POLICY:  I understand that the full payment is due at the end of every service

- AFTERCARE POLICY: I understand and agree to the aftercare instructions provided by the lash artist, for the use and care of my lash extensions/lash lift. I understand and accept the consequences of the failure to adhere to these instructions may cause the lash extensions to fall out prematurely/decrease the length in time which the lashes/lift will last. I understand that if any follow-up care is required due to my own mistake or failure to follow these instructions, this will be at my own expense and risk. 

- REMOVAL POLICY: I understand that I should not attempt to remove my eyelash extensions on my own or with any product, and that the procedure requires that my eyelash extensions be professionally removed by a licensed professional.

- RISK POLICY: I understand that there are risks associated with having artificial lashes applied or removed from my natural lashes, as well as having a lash lift performed performed. I understand that eyelash extensions and lash lifts have some inherent risk of irritation to the orbital eye area, including the eye itself, and could result in stinging, burning, blurry vision, and potential blindness should the adhesive or lift creams enter the eyes or should an allergic reaction occur. I agree that of I experience any of these conditions with my lashes that I will contact my lash artist immediately and it may be beneficial to have the lash extensions removed/seek medical attention.

- LIABILITY POLICY: I give permission to my lash extension/lash lift specialist to perform the lash extension procedure we have discussed., and will hold him/her and his/her staff harmless and nameless from any liability that may result from this treatment. I have accurately signed to all of the statements to questions above. I understand that my lash extension/lash lift specialist will take every precaution to minimize or eliminate negative reactions as much as possible. In the event that I may have additional questions or concerns regarding my treatment, I will consult the lash extension/lash lift specialist immediately. I agree that this constitutes full disclosure, and that it supersedes any previous verbal or written disclosures. 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/lash lift specialist responsible for any of the conditions that were present, but not disclosed at the time of the procedure, which may be affected by the treatment performed today. I understand that there is a strict NO REFUND policy following this procedure.