Eyelash Extension Consent & Waiver of Liability

Eyelash Extension Consent & Waiver of Liability
Although every precaution will be taken to ensure your safety and wellbeing before, during and after your lash extension application, please be aware of the following information and possible risks.
Name

First NameLast Name
Date of Birth

DayMonthYear
Date
Email
example@example.com
Phone Number

Area CodePhone Number
Have you ever had eyelash extensions before?
If yes, what type and was there any discomfort during or after the procedure?
Have you had any allergies or an allergic reaction?
If yes, please clarify...
Do you have or had any of the following ?

Other
Please add anything else you may seem appropriate that could effect having eyelash extensions.
CLIENT WAIVER & RELEASE

Please read each statement and acknowledge by checking each box by doing so you have READ, UNDERSTOOD and AGREE to the TERMS.
Please read each statement and acknowledge by checking each box:

I understand that in rare occasions there are risks associated with having artificial eyelashes and eyelash extensions applied to or removed from my natural eyelashes. I further understand that in rare cases as part of the procedure eye irritation and discomfort could occur. I agree that if I experience any of these conditions with my lashes that I will contact the certified eyelash extension professional that performed this procedure and it may be beneficial to have the eyelashes removed.
I understand there are risks associated with having artifical eyelashes applied to and/or removed from my existing eyelashes, and that not withstanding the utmost of care in the application or removal of these products, there still risks associated with the procedure and product itself, which include, without limiation, eye irritation, eye pain, discomfort, and in rare cases, blindness even when applied in the usual manner.
Parents Signature if underage
Signature
Should be Empty:

Eyelash Extension Consent & Waiver of Liability

CLIENT WAIVER & RELEASE