Eyelash Lift/Tint Consent Form

Eyelash Lift/Tint Consent Form
Name

First NameLast Name
Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Best way to contact you?
Email
example@example.com
Occupation
How did you hear about Karina’s Beauty Spa
Have you done a Lash Lift in the past?
If so, how long ago?
I am informing my technician of any of the following contraindicated conditions for the lash lift.
I am informing my technician of any of the following contraindicated conditions for the brow lamination.
I consent to having my eyes closed and covered for the duration of the 60-75 minute procedure.
I wear contacts
- I agree, Although every precaution will be taken to ensure your safety and well-being before, during, and after your eyelash lift, please be aware of the following information of possible risk.
- I understand that there are risks associated with having an eyelash lift
- I understand that as part of the eyelash lift procedure, eye irritation, eye pain, eye itching, discomfort, and in rare cases, eye infection or blurriness could occur.
- I agree that if I experience any of these conditions with my eyelashes or eyes that I will contact my technician; if I choose to consult a physician, it will be at my own expense.
- I understand that the instruments, tapes, cleansers, eye gel pads, adhesives, and/or removers may irritate my eyes or require physicians follow up care, even though my technician utilize correct techniques and follow proper safety protocols.
- I understand an eyelash lift will lift my natural lashes. Depending on my natural lash lift length and strength, results may vary.
- I understand and agree to care instructions provided by pack technician for the use in care of my eyelashes after the eyelash lift. I realized it a sept that the consequences of failure to adhere to these instructions may cause the eyelashes to not stay as lifted as long as originally told.
- I understand the consent to having my eyes closed and cover for the entire duration of the procedure.
- I understand I should come in makeup free to my appointment
- I understand if any cancellations or rescheduling with less than 24 hours of notice or no-show appointments are subject to a cancellation fee amounting to 50% of the cost of the scheduled service.
- I understand NO REFUNDS. All purchases are FINAL SALE.
I understand and agree the above
I agree to the following Post- Lash Lift:
Acknowledgement and Waiver

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. 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, weather conditions, and activities involving exposure to high temperatures. By signing below, I verify that I have read and understand the above statements and agree to them.
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Signature
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