Lash and Brow Tinting Consent Form

Lash and Brow Tinting Consent Form
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Email*
example@example.com
How did you hear about us?*

InstagramGoogleFacebookFamilyFriendWalk InOther
Emergency Contact*

Full NameCell Name
Our Policies

Please take a moment to complete our consent form. By submitting the form below you agree to knowingly and willingly consenting to our policies and procedures.
24- hour notice is required for any canceled or rescheduled appointment or up to 100% of service price will be charged. Failure to show without notice will require in full payment of service booked. We do not offer monetary refunds on services rendered. We do have a 7-day policy in place on services in which a client can come back and have corrections made. Client must contact provider within 24-48hours after service rendered of any issues. Fees may apply. By choosing yes, I’m acknowledging I have read, understand, and agree with the terms of these policies.*

Yes
Have you ever used hair color before?*

YesNo
Have you ever had an allergic reaction to hair color?*

YesNo
Do you wear contacts?*

YesNo
To help with the comfort of your eyes, your contacts may need to be removed during lash tinting.
Have you ever had your brows or lashes tinted?*

YesNo
List any known allergies:*
N/A if none
If you had an adverse reaction to a previous tinting, please explain:
Although every precaution will be made to ensure your safety and well-being before, during and after your tinting application, please be aware of the possible risks below:
I understand that tinting lashes or brows has some inherent risk of irritation to the orbital eye area, including the eye itself, and could result in stinging or burning, blurry vision and medical attention may be required.*

Yes
I understand that if the tinting agent, developer, or mixture of both accidentally comes into contact with my eye, my eye will be flushed with water and medical attention may be required.*

Yes
I understand that some irritation, itching or burning may occur to the skin which comes in contact with the tinting agent.*

Yes
I understand that there may be some residual dark staining left on the skin following the tinting process of either my lashes, brows or both. This will fade and go away within a short time.*

Yes
I understand that, while every attempt will be made to provide me with my chosen color, everyone’s hair absorbs color differently and my final results may not be the color I initially wanted.*

Yes
I understand that over the course of several weeks, the tint will gradually lighten and fade. Re-tinting will be required to keep the new color fresh. Most clients need to re-tint every 3-4 weeks.*

Yes
Signature*

Clear
Parents must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.
Parent/Guardian Signature:

Clear
Should be Empty:

Lash and Brow Tinting Consent Form

Our Policies