Lash Extension Consultation Form
THIS IS NOT AN APPOINTMENT. THIS IS A CONSENT/CONSULT FORM. To book, please visit montxesthetics.glossgenius.com before submitting this form. All new clients must submit this form within 24 hours of your appointment request (via aforementioned link) in order to be accepted. If you have not been serviced by Mont. Esthetics for more than a year, you are considered a new client.
Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
Date of Service
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Month
-
Day
Year
Date
Preferred Language
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English
Spanish
Both
Reason for Appointment
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Daily Wear
Special Event
What lash set are you interested in?
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Classic
Volume
Wispy Volume
Wet Set
I’m not sure
Please upload an inspiration photo of your desired look for better understanding.
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Please check below if you have the following medical condition:
*
Yes
No
Remarks
Contagious or eye infection disorder Eg. Conjunctivitis
Hypersensitive skin
Stye (an abscess filled with puss caused by staphylococcus bacteria)
Swelling of the eyes
Cancer
Herpes
Cuts or open wounds in the area
Epilepsy
Claustrophobia
Unhealed Semi-Permanent make up Eg. eyeliner
None of the above
Pregnant
LIABILITY
I consent to the waxing services provided by MONT. ESTHETICS, LLC. (referred to as "The Esthetician". I understand that there are risks associated with having artifical eyelashes applied to and/or removed from my natural lashes.I understand that as part of the procedure, eye irritation, pain, itching discomfort and in rare cases, eye infection may occur.I understand and agree that if I experience any of these issues with lashes I will contact my technician and have the eyelash extensions removed immediately and consult a physician at my own expense. I understand that even though the technician may apply and remove the eyelash extensions properly, that adhesive material may become dislodged during or after the [procedure, which may irritate my eyes or require further follow-up care.I understand that to have eyelash extensions applied, I will need to keep my eyes closed for a duration of 60-180 minutes during the procedure. I also understand that I will be lying in a reclined position. Any medical conditions that might be aggravated by lying still for a prolonged period may mean that I will not be able to have the procedure performed on my eyes.This agreement will remain in effect for this procedure and all future procedures conducted by my technician. I understand that this is binding and that I have read and fully understand all the information above.The Esthetician reserves the right to refuse service for any reason deemed appropriate, including but not limited to behavior that is disruptive, disrespectful, or poses a risk to the safety and well-being of staff and other clients.I release MONT. ESTHETICS, LLC. from all liability associated with this procedure. There are no guarantees for the bonding time length of the eyelash extensions. I understand that I have been advised to follow the aftercare protocol from my technician to avoid any discomfort or aderse side effects after the procedure has been completed.I acknowledge that I confirm I am either at least 18 years old or accompanied by a legal guardian & I have read, understood, and agreed to the terms and conditions outlined in this Agreement.
NEW CLIENT DISCLAIMER
First time getting lashes? Going on a trip? It is recommended to schedule your Full Set appointment at least 3 weeks prior to your vacation to make sure you do not have an allergy! The last thing you want is to spend your trip with an allergy and no way to remove the extensions without completely damaging your natural lashes (and no, oil does not work.) If you do not have an allergy, we can set you up with a Maintenance appointment right before your trip.
CREDIT CARD AUTHORIZATION
I (the Client) understand and agree that all services completed are non-refundable and final. I (the Client) understand that if appointment is not cancelled less than 12 hours of scheduled time, I will be charged 100% of service costs. I (the Client) understand that if I no-call no-show, I will be charged 100% of service costs. I consent to MONT. ESTHETICS, LLC. (the Business) charging the card I have provided upon booking without disputes.
SOCIAL MEDIA CONSENT
I (the Client) give my consent to MONT. ESTHETICS, LLC. (the Business) to use my photographs for promotional purposes on flyers and/or social media platforms including, but not limited to Instagram, Facebook, and TikTok.I confirm that I have read, understand, and agree to all the information as stated above.
LASH POLICY SEBRING
BOOKING AGREEMENT
MONT. ESTHETICS, LLC. requires a Credit Card on file for all booked appointments (YOUR CARD WILL NOT BE CHARGED UPON BOOKING.) If booking online, there is no deposit required. If booking directly through me (text, dm, etc.) a non-refundable deposit of 50% of service costs is required. Deposit must be sent VIA: Cashapp $MONTESTHETICS and will go towards service costs. The remainder of the service costs must be paid via debit/credit, cash, or cash app on the day of the service. Deposit must be made within 24 hours of booking or the appointment will be canceled. No credit card/deposit = no appointment
CANCELLATION/ RESCHEDULING
Please cancel/reschedule your appointment AT MOST 12 hours before your scheduled appointment. Anything less will result in a fee of 100% of service costs. The card on file will be charged. To avoid a fee, you may reschedule past the grace period, only valid one time per appointment and no more than 7 days from the initial appointment. If rescheduling within the grace period, there is no fee.
NO-SHOWS
All no-shows will result in a no-show fee. Fee equals 100% of service costs. The card on file will be charged. Rescheduling is available at this point with a new 50% deposit. No-call-no-shows will be banned from booking any future appointments.
LATE
All appointments are granted a 10-minute grace period. Anything late beyond 10 minutes will result in cancellation. No time will be added to your appointment if you are late within the grace period. The service MUST have begun at the exact 10-minute mark, if you are just arriving by the 10-minute mark the appointment will be canceled. 50% of the service cost will be charged to the card on file. If time allows, OR if rescheduling, the fee is waived.
NO MAKEUP/CONTACTS
Please make sure to come in with no face or eye makeup to allow for tape/lash application and to keep the appointment within its allotted time. Any client who comes in with makeup on or around the eyes will be charged a lash bath fee of $10. Any client who comes in with waterproof mascara and/or eyeliner will not be accepted and will be charged a fee (50% of the service cost to the card on file.) PLEASE REMOVE CONTACTS PRIOR TO THE APPOINTMENT. They will burn your eyes if in contact with fumes.
AFTERCARE
Aftercare instructions and tips are thoroughly explained after your service. It is crucial to follow the steps provided to you to maintain proper retention and lash health. The artist can see whether or not proper aftercare is being followed by the state of your lash line and lash extensions. Failure to comply with aftercare for an extended period of time can result in eye irritation and infections (as discussed during the appointment.) In severe circumstances, the artist and business, MONT. ESTHETICS,LLC., is not liable for any damage and the client can and will be refused service and charged a cancelation fee if applicable (50% of service costs to the card on file.)
COMPLIMENTARY 3-DAY FILLS
MONT. ESTHETICS, LLC. offers complimentary 3-day fills if you experience excessive fallout soon after your appointment. The touch-up appointment must be made within 3 days after the full set/refill appointment. A free touch-up will not be granted after the 3-day period.
FOREIGN FILLS
Foreign fills will not be accepted. Exceptions will be made for travelers.
GUESTS
Please have your guest wait in the salon lobby.
DISCOUNTS (all)
Discounts will not be applied to lash baths if the client arrives with make-up. Discounts cannot be combined. Discounts are forfeited if the client is late past 15 minutes, the Client cancels/reschedules past the grace period, or if the client no-shows.
NO CAFFEINE
Please do not drink ANY caffeinated drinks on the day of your appointment.
HEALTH
When booking, you confirm that you are not sick or experiencing COVID-19/Flu/Cold-like symptoms. If you have any medical conditions or are currently taking any medications, you must speak that to your lash artist (medical conditions/medications can affect retention by increasing your average amount of hair loss.)
STYLING
Your desired look is always taken into consideration, however, certain lengths and styles are not always achievable due to the state of the natural lashes. Professional recommendations will be given to allow the natural lashes to continue their growing cycle without harm. If the client chooses to go against recommendations, the artist and business, MONT. ESTHETICS,LLC., are not liable for any damage.
Signature
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Date Signed
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Date
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