• Lash Lift and/or Tint Intake Form

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

  • Lash Lift and/or Tint History

  • Have you had a lash lift and/or tint before?*

  • Medical History

  • Do you wear contact lenses?*
  • Do you have frequent eye irritation, itching, or watery eyes?*
  • Are you pregnant or breastfeeding?
  • Do you have any of the following conditions? Check all that apply*

  • Acknowledgement and Waiver

    Although every precaution will be taken to ensure your safety and wellbeing before, during and after the lash lift and/or tint process, You are aware of the following information and possible risks as follows: 

    -I understand that lash lift and/or tint has some inherent risk of irritation to the orbital eye area, including the eye itself, and could result in stinging, burning or blurry should the perming solution enter into the eye.

    -I understand that if the lash lift and/or tint products accidentally comes into contact with my eye, my eye will be flushed with water and medical attention may be required.

    -I understand that it is imperative that I disclose all of the information required on the consent form

    -I agree that if I experience any ill effects with my lashes that I will contact WAxxd Studio & Aesthetics.

    -I understand that I need to keep my eyelashes free of water for 48 hours after the lash lift treatment.

    -I understand and agree to the after-care instructions provided by WAxxd Studio & Aesthetics. I realize and accept the consequences of failure to adhere to these instructions.

    I acknowledge that the esthetician at WAxxd Studio & Aesthetics do not provide medical advice and I accept full responsibility to seek out such advice before receiving any services or products from WAxxd Studio & Aesthetics. I hereby release, discharge and waive any and all claims against WAxxd Studio & Aesthetics and esthetician performing services or applying any products at WAxxd Studio & Aesthetics, including from liability and responsibility for any and all illness, injuries, damages, claims, rights and causes of action of any kind or nature, that may occur during or arising out of any services or products received on this and any future dates. I expressly assume and accept the risk for any injuries sustained. I have read this entire document and agree to its terms.

  • Everyone's time is valuable; Therefore, I have the following policies in place:

    CANCELLATION POLICY:
    Cancellations made within the 24-hour window will incur a 50% charge of the service fee to the client's card or paid via Venmo.

    NO SHOW POLICY:
    This is a zero-tolerance policy! No-show appointments will incur a 100% charge of the service fee to the client's card or paid via Venmo.

    LATE POLICY:
    I allot 10 minutes past the scheduled appointment time for clients that may be running behind. This helps to ensure I stay on time for all the appointments to follow. If it has reached 10 minutes after the scheduled appointment time, I will need to reschedule the appointment and you will be charged 40% of the service.

    RESCHEDULING POLICY:
    Similar to cancelling the appointment; The client will be charged a fee to reschedule if it is within the 24-hour window. The rescheduling fee will be $30.00 and an additional $15 hold fee to go towards rescheduled appointment. If the rescheduled appointment has to be cancelled a second time within the 24-hour window there will be a 50% charge of the service fee. If cancelled a third time client will automatically be charged the full amount of service fee and no longer be able to schedule appointments with me.

    Please Note:
    Shall any of the charges not be fulfilled, the client will no longer be allowed to book future appointments until payment is received.
    Failure to follow my policies or multiple violations will result in restrictions to booking and possible termination of my services.

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