CLIENT WAIVER & CONSENT FORM

NEW CLIENT WAIVER & CONSENT FORM

LASH THERAPY LAB
Hello! Thank you for choosing Lash Therapy Lab for your Eyelash Extension services! This form contains all the relevant guidelines for a satisfactory and most importantly, safe and relaxing experience.

Please read and complete this document carefully and contact Natalie Tomczyk with any questions or concerns. I look forward to seeing you at your appointment!

All policy/ pricing and appointment information can be found at lash_therapy_lab on Instagram.

LOCATION/ ADDRESS:

35 Burke Circuit, Eyre 5121

Home-based.
Parking available on the street.
Booking Policies: By booking I acknowledge I have read and agreed to the booking policies below.

PLEASE TRANSFER YOUR DEPOSIT TO THE DETAILS BELOW:

NATALIE TOMCZYK

BSB: 805 050

ACC: 102 925 896

Booking Fee/ Deposit: A deposit of $50 is required at the time of booking, this reserves your appointment time and is deducted from your total fee on the day of yourq appointment.

eg: A full set of lashes costing $130 - the $50 deposit = $80 remaining on the day.(Payable by cash or bank transfer).

This deposit also acts as a last-minute cancellation fee in the event of a last-minute cancellation (within 24hrs of your appointment time). This fee is therefore NON-REFUNDABLE as it compensates the service provider when your appointment cannot be replaced at short notice.

Appointment Timing: I acknowledge that the timing for full-set appointments is approx 2-2.5 hours. Refill appointments are approx 1.5 hours.

I have informed Natalie Tomczyk of any time constraints I may have before booking my service.

After 15+ minutes, your appointment will be CANCELLED and you will be charged a no-show fee of 100% of the service. You will receive an invoice which MUST be paid prior to re-booking and upfront payment will be requested in reassurance that you attend your appointment.

If you "no-show" a second time, you will be banned from future bookings.

Refill Policy: Please book a removal and full-set if you are coming with lashes from another salon. Removals are half-price with a full set.

You must have a MINIMUM of 50% in-tact lashes remaining to be considered a refill. Anything less will be charged as a full-set. Please send a photo if you are unsure.

Please book refills as close as possibly to every 14 days (2 weeks)

**Appointments past 21 days (3 weeks) will automatically be charged as a FULL-SET as by this time the lashes require more maintenance, time and product for optimal results **

Please note some clients may also shed lashes faster than others due to their natural lash cycle and lifestyle.

Children/ Partners or Visitors: Please attend your appointment alone. The space and nature of the service allows for one client at a time.

Photographs/ videos: I consent to photographs or videos being taken before, during and after the service. This may include: Me, my face, eyes/ eyelashes. I grant Natalie Tomczyk and/or Lash Therapy Lab the full rights to take, publish, re-touch and reproduce photographs or videos, which may be used for marketing, education or other purposes on social media and other platforms.

Refunds/ Satisfaction Guarantee: I understand that lash extensions are a luxury service that require the professional's time and use of products; therefore all services are NON-REFUNDABLE. If I am unhappy with the service received, I will contact Natalie within 48hrs for a resolution to be discussed. I understand that my unique eye-shape and natural lash density may impact my final results.

Your satisfaction is my top priority! You may be offered a complimentary touch-up where appropriate. Please submit any feedback to me directly. Remember that you are always welcome to message me with any questions or concerns!

Appointment Preparation:

• Avoid caffeine/ energy drinks the same day of your appointment

• Avoid waterproof mascara for at least 2 days prior

• If you are booked for a refill but need a full set, please let me know ASAP

• Remove any and ALL make-up and skin-care, cleanse face thoroughly! Extensions will not adhere to dirty lashes and your retention and results may be compromised

• Turn phone and/ or smart-watch to silent to avoid disruptions

• Please do not bring any extra people to your appointment

• Remove contact lenses if you wear them

• Use the bathroom, dress comfortably and prepare to relax!

Arriving To Your Appointment:

PLEASE DO NOT approach the premises until you have sent me a message and please wait for me to respond. I may still be with another client or preparing for your appointment.

Arrive early, be sure to account for traffic.

Our address can be found at the top of your consent form, please make sure you check this prior to the day as I'm not always able to respond immediately to messages.

DO NOT attend your appointment if you are sick/ unwell (refer to cancellation policy).

Plenty of street parking available.

Payment must be completed prior to leaving your appointment. l accept both cash and bank transfer. (Please bring correct amount if paying by cash).
WAIVER OF LIABILITY AND CONSENT TO SERVICE:
I give Natalie Tomczyk permission to perform the Lash Extension procedure we have discussed, and will hold her harmless and nameless from any liability that may result from this treatment.

I do not hold Natalie Tomczyk or Lash Therapy Lab responsible for any of my conditions that were present but not disclosed at the time of this procedure, which may be affected by the treatment performed. By signing this form, the customer agrees that he/she accepts all information, suggestions, and recommended activities or treatments provided by the Lash Technician. I agree to defend, indemnify and hold harmless Natalie Tomczyk or Lash Therapy Lab from any and all claims, actions, expenses, damages and liabilities, including reasonable attorney's fees which might be asserted against them as a result of having this procedure performed.

I have accurately answered the statements or questions below and disclosed any allergies, prescription medications or products that I have ingested or used topically.

I will consult with my lash technician if I have questions or concerns regarding the service. I agree that this constitutes full disclosure, and it supersedes any previous verbal or written disclosures.

REACTIONS/ IRRITATIONS/ INJURIES AND RISKS: I further understand that as part of the procedure, eye irritation, eye pain, eye itching, discomfort, and in very rare cases eye infection or blindness can occur. I agree that if I experience any of the above, I will contact Natalie Tomczyk immediately and have the extensions removed. I will consult a physician at my own expense as soon as possible.

I understand that even though the lash technician applies or removes the extensions using the proper techniques, the instruments, tapes, cleansers, eye-pads, adhesives, and removers may irritate my eyes or require a physician's follow-up care and subsequent removal of the eyelash extensions.

I understand that adhesives and adhesive removers are a skin, eye and mucous membrane irritant and that in some cases persons may be allergic or have hypersensitivity to synthetics. I understand that a certain amount of eyelash adhesive material will be used to attach the eyelash extensions to my natural eyelashes. I understand that in very rare cases this material (or the extensions themselves) may become dislodged during/ after the procedure which may cause irritation or injury.

I understand that allergic reactions to lash adhesives can develop at any time and I have waived a FREE patch-test (or already had one completed by Natalie Tomczyk). I agree to disclose any previous allergic reactions.

CARE AND MAINTENANCE:
I understand and agree to the after-care instructions provided by the service provider. If any follow-up care due to my own mistake or negligence, or failure to follow these instructions this will be at my own expense. I accept that the consequences of failure to adhere to these instructions may cause my eyelash extensions to fall out, damage my natural eyelashes and/or decrease the time my extensions will last (retention).

This agreement will remain in effect for this procedure and all future procedures conducted by Natalie Tomczyk. I read English and understand that this consent agreement is legal and binding. I have read and fully understand all information in this agreement. I am over 18 years of age and consent to the agreement and to the treatment. If I am under 18 I acknowledge that my parent or guardian has signed this form with their permission, on my behalf.

By signing below I verify that I have read and understand the above statements and agree to them.
Please mark all boxes:*

I understand that I forfeit my booking deposit should I fail to uphold the cancellation guidelines above.I will not bring any children, partners or visitors to my appointment.I give Natalie Tomczyk and/or Lash Therapy Lab full rights to pictures taken during my service.I agree and understand the no refund policy provided by Natalie Tomczyk and/or Lash Therapy Lab.I consent to service without a patch/ sensitivity test (unless this has already been done by the service provider).I agree that I will remove all make-up/ skin-care prior to attending my appointment.I agree that I may be refused service if I disrespect the service provider or fail to follow the pre-appointment guidelines listed here.I acknowledge I have no known medical conditions that may affect the service (or have disclosed this information prior to booking).I agree to the appointment timing listed above and will avoid rushing my service provider, as I am aware that this service requires a certain level of skill and precision.I am aware and agree to removing contact lenses (if worn) prior to my appointment.I will avoid wearing waterproof mascara up to 2 days prior to my appointment.I will advise my service provider of any known lash damage prior to the appointment.I understand that my eyes must remain shut for the duration of the service (unless advised otherwise) as to avoid eye-irritation or injury. I will inform my service provider if I need to open my eyes.I agree to any after-hours/ public holiday or additional fees.I understand that my service provider does not work over other eyelash technician’s work and that I will need a removal and full-set. NO FOREIGN FILLS, sorry!I understand I must have at least 50% of my extensions remaining to qualify for a refill. I understand my service provider may charge for a full-set if I attend my refill appointment with less than 50%I understand that any future appointments past 21 days (3 weeks must be booked as a full-set or I will be charged accordingly).I will avoid caffeine prior to my appointment as this can result in my body being in an un-safe, restless state, where the use of sharp tools and chemical products can cause irritation or injury.I understand that I must remain still throughout the service. I will advise the service provider if I need to move or use the restroom to avoid any irritation or injury.I have discussed my desired results with the service provider. (Please direct message).I understand that arriving 15+ minutes late to my appointment will result in cancellation (unless otherwise discussed) and I will forfeit my booking deposit.I understand that I must notify the service provider of my arrival (via direct message or text) and only approach the premises once confirmed.
I agree to the following Eyelash Extension Aftercare/ Maintenance advice:*

No mascara to be applied to extensions.I will only use oil-free products on my face/ eye area, including cleansers and wipes.I will avoid contact with water, steam, extreme heat and sweat for 24 hours after application (this includes showers, spas/saunas, pool, etc).No tinting or perming of eyelash extensions post application.No continuous pulling, picking, or rubbing of the extensions.No curling of the lashes or application of false lashes over the extensions.I will clean and maintain my extensions with an approved cleanser, clean water and a soft-bristle brush DAILY (following the initial 24 hours after application/ treatment).I will brush my extensions daily with the lash brush/ spoolie/ wand provided.I will not attempt to remove my lash extensions myself (only by a certified service provider).
Signature*

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Please check any of the following that apply to you:

Allergy to adhesives (glues or tapes)Current pregnancy or recent child-birthThyroid condition or medicationGlycerin or latex allergyChemotherapeutic agentsDry eyesWatery eyesSensitive eyesWear contact lensesAlopeciaRecent Eye SurgeryGlaucomaUse of eyelash serums within last 4 weeksOily skin and/ or hairExtreme stress or hormonal imbalanceSeasonal allergiesClaustrophobiaOther
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NEW CLIENT WAIVER & CONSENT FORM

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