Muse 2870 Eyelash Extensions Consent Form and Waiver

Consent Form

I agree to have eyelash extensions applied and/or removed to my natural eyelashes by Muse 2870 who is a certified eyelash extension technician. I understand that I must complete this agreement and provide my details that are required in order to receive eyelash extension treatment/s. 

I AGREE TO THE FOLLOWING:

I understand that there are risks involved with having artificial eyelashes applied and/or removed from my natural eyelashes. I understand as a result of this treatment that I may experience:

- Eye irritation
- Eye pain
- Eye itching or discomfort

In very rare circumstances:

- Eye infection
- Damage to the eyes

I understand and agree that if I experience a reaction as a result of having artificial eyelash extensions applied that  I will contact a doctor for advice and if necessary my eyelash technician will remove the extensions at my own cost. 

Even though the certified professional may apply or remove the eyelashes correctly, I understand that adhesive material may become dislodged during or after my appointment which may result in irritation or further aftercare. I also understand that eyelash extensions are semipermanent and require ongoing appointments to maintain results following the natural shedding cycle of natural eyelashes. 

I agree to follow aftercare instructions provided by Muse 2870. Failure to follow these instructions can cause the eyelash extensions to fall out, damage the extensions or natural lashes and/or decrease the appearance and quality of the eyelash extensions.

I understand that in order to undergo this treatment, I will need to keep my eyes closed for 60+ minutes during the appointment and remove glasses or contacts. I also understand that I will need to lie on a table holding still. I agree to inform Muse 2870 of any medical condition that may be aggravated by lying still for an extended period of time. The procedure will not be performed if any condition/s will be  aggravated without doctors approval. 

This agreement will remain in place for this procedure and  any future eyelash extension procedures performed by Muse 2870. 

I understand that this agreement is binding and that I have read and fully understand all information provided above and that I am above the age of 18. If under 18, my parent/guardian will sign for me and accept this agreement on my behalf. I certify that the information that I have provided on this form is true and accurate. 

 

 

Waiver

 

I authorise Muse 2870 to apply semi permanent artificial eyelash extensions to my natural eyelashes. I understand that it is my responsibility to keep my eyes closed during the entire process until otherwise advised. The risks of this cosmetic procedure have been disclosed to me. Some instances may result in complications such as redness, irritation or allergic reactions to the adhesive or eye pads. If at any time Muse 2870 or I are uncomfortable with the treatment, the technician will gladly rectify the issue, including but not limited to ending the appointment.  I acknowledge that no guarantees, warranties, commitments or other statements have been presented to me by Muse2870. I am consenting to this treatment at my own risk. Additional conditions may be discovered during the eyelash extensions procedure; e.g allergies that could affect the result of the procedure or my ability to complete the procedure. All allergies or reactions must be discussed with a doctor prior to or after my appointment.

I understand that eyelash extensions require my careful maintenance in order to receive the expected longevity of the treatment. I understand and agree that for 24 hours I must not have a hot or steamy shower/bath, use a sauna room or swimming pool, use a solarium, oils, lotions, creams, shampoos, face washes or makeup removers on my eyelashes. Do not use waterproof mascara or eyelash curlers are all appointments.  Excessive use of oil based products will be avoided as well. I release Muse 2870 or anyone affiliated with the eyelash

 technician including partnerships or companies associated from any claims or damages, regardless of nature. I release Muse 2870 of any responsibility for any medical conditions I have not disclosed or any that may arise as a result of the treatment. I understand that I am fully responsible for any medical treatment that I may need to receive as a result of the treatment. 

Please read the following statement, sign and date where indicated to indicate you have fully read and understand this waiver.

I, the client, certify that I have read and fully understand the above waiver. I authorise that I have consulted with Muse 2870 in regards to any questions or concerns I have had regarding eyelash extension treatment/s. I certify that I am fully capable of understanding and signing this waiver. I, the client, acknowledge and understand that there may be unknown risks associated with the treatment and am fully responsible for physical, financial or physical issues that may arise.

If under 18, my parent/guardian will sign and accept all consents on my behalf.