Lash Lift & Brow Lam Consultation & Consent Form

  • Lash Lift/Tint + Brow Lamination ConsultationForm

  • Client Information

  • Date of Birth
     - -
  • Format: (000) 000-0000.

  • Emergency Contact
  • Format: (000) 000-0000.

  • Medical History

  • Do you have or have you had any of the following conditions? If yes, please select them:
  • Are you allergic to the following?
  • Do you wear glasses?
  • Do you were Contact Lenses?
  • Do you have, or are you being treated for any eye illness/injury?
  • Do you often have eye irritation, itching or watery eyes?

  • Eyelash & Brow History

  • Have you ever had an eyelash lift, tint, or brow lamination before?

  • If yes:
  • Have you ever had an adverse reaction to an eyelash tint, lift, or brow lamination?

  • If yes:
  • Do you use any of the following products on your eyelashes?
  • Do you currently have any other lash or brow procedures? (Lash extensions, etc.)

  • If yes:
  • I give permission to the lash technician to perform the following procedures:

  • I completed the above form to the best of my knowledge. I have had the opportunity to ask any questions and have received satisfactory answers. I will inform the technician of any changes to the above information. I will not hold the technician, salon, or employees liable for any issues not disclosed at the time of my service or any adverse effects from the lash lift, brow lamination and/or tint procedure.

  • Client Consent Form

  • I hereby consent to and authorize to perform the following procedure:
    the eyelash lift and tint, and the brow lamination procedures are performed with the proper technique, products, and instruments, and with your safety in mind. however, there still are some risks associated with the procedure(s). This consent form is intended to inform you of the risks of the procedure(s) and to obtain your informed consent for the procedure(s).

  • Please check each statement:

  • I completed the above form to the best of my knowledge and consent to the lash lift, brow lamination, and/or tint procedure. I have had the opportunity to ask any questions and have received satisfactory answers. I understand the risks and potential side effects associated with the procedure(s). I understand that the results of the procedures are not guaranteed and may vary from person to person. I am over the age of 18 and consent to the procedure(s). I will not hold the technician, salon, or employees liable for any issues not disclosed at the time of my service or any adverse effects from the procedure(s). This agreement remains in effect for this procedure and any follow-up appointments.
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