• Client Consultation / Consent Form

    Lash Extensions
  • Client Information

  • Birth Date*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Format: (000) 000-0000.
  • Medical History

    The following questions are necessary to determine if you have any contraindications that would prevent the application of eyelash extensions or put you at a higher risk for adverse reactions.
  • Have you ever had previous allergic reaction(s) to eyelash extensions or other eye treatments (Swelling, itching, burning, redness)?*
  • Do you currently have or have you recently had any eye injuries, infections or inflammation (Styes, Blepharitis, Conjunctivitis / Pink eye, HSV Keratitis, Cysts)?*
  • Please check any of the following that may apply to you:
  • Which lash extensions are you interested in booking in for?*
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  • Full Face Analysis

    Now offering a free in depth full face analysis for every new client upon booking. 
  • Lash extension styles are not a one size fits all. The anatomy of our face and our diverse facial features can play a huge role in the results of a finished lash look. During this analysis I take measurements and consider eye shape, proportions and face shape. This analysis helps determine the perfect tailored lash design that will best suit you!

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  • POLICIES:


    Deposits:

    Upon booking a non-refundable 50% deposit is required to secure your appointment. The deposit comes off the service total and remainder is owed on appointment day. Appointments will not be booked until deposit is received.

    Rescheduling and Cancellations:

    At least 24 hours notice is required upon rescheduling appointments. Failure to give proper notice will result in forfeit of the deposit. Due to the nature of these services and supplies needed, and before committing to the booking please understand the deposit is non-refundable for all cancellations.

    Late:

    Please contact me if you’re running late to your appointment. I give a 15 minute grace period, after that a late fee of $15.00 will be applied. You may be required to reschedule your appointment resulting in a forfeit of deposit.

    No shows:

    No shows are not tolerated and will result in loss of the deposit. No future bookings will be permitted.

    Refunds:

    I do not give refunds on any services rendered. Please notify me if any problems / concerns arise regarding your service within 72 hours after your visit. I will correct problems within that time frame. If you arrive to your appointment with eye makeup on you will not qualify for the 72 hour fix guarantee.

    Allergic reactions:

    Allergic reactions generally present within the first 72 hours after the service, but can develop at any time. In the occurrence of this happening removal of the extensions is necessary. Please contact me immediately if any signs of an allergic reaction are present. You should also seek medical attention as I'm not a doctor and can’t give out any medical advice.
    Allergic reactions do not qualify for refunds.

    Fills:

    To maintain the look of your lash extensions fill appointments are recommended every 2-3 weeks. If at anytime you have less than 40% of the extensions per eye the purchase of a full set will be required.

    Foreign Fills:

    I do take on other artists work, but require an in person consultation before committing. During the consult I will decide whether or not the fill appointment can be proceeded with. A removal may be suggested. At least 40% of the lash extensions must be present or full set pricing will be applied. There is a $20 fee on top of the fill price for all foreign fills.

    Aftercare:

    The aftercare of your lash extensions is crucial part in your lash health and retention. Failure to do so can result in eye infections and poor retention. Following the after care steps given can help you get the most of your lash extensions. 

    After Hours:

    An after hours fee will be applied to all appointments outside of my works hours. 
    Lash fills additional fee is $20, Lash full sets additional fee is $40. 

    Refusal:

    I have the right to refuse any service I’m not comfortable with or that is not safe in providing.

     

  • Treatment & Aftercare Consent

  • I understand and agree to the following:*
  • Liability Waiver

  • I hereby release, indemnify, and hold harmless [With Brit] and the Eyelash Extension Technician from any and all liability, claims, demands, damages, and causes of action arising out of or related to any loss, damage, or injury, including death, that may be sustained by me or my property, arising out of or in connection with the eyelash extension procedure.

    I understand that if I experience any pain, discomfort, or symptoms of a possible allergic reaction (redness, swelling, itching, excessive tearing) after I leave, I should contact a medical professional immediately.

    By signing below, I acknowledge that I have read, understood, and agreed to all sections of this Eyelash Extension Medical History, Consent, and Liability Waiver Form.

  • Signed Date*
     / /
    2 digit month, 2 digit day, 4 digit year
  • Signed Date
     / /
    2 digit month, 2 digit day, 4 digit year
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