• Lash Lift/Tint Brow Lamination Consultation Form

  • Birthdate*
     / /
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.

  • Do you have any of the following conditions (check all that apply):

    Are you currently being treated for an eye illness, eye injury, or skin condition? YES NO

  • Do you have any of the following conditions (check all that apply):*
  • Are you currently being treated for an eye illness, eye injury, or skin conditions?
  • Do you currently have irritated, itchy, or watery eyes?*
  • Are you allergic to perms, hair color, or tape?*
  • Are you currently pregnant?*
  • Have you ever had an eyelash tint, lift, or brow lamination before?*
  • Have you ever had an adverse reaction to an eyelash tint, lift, or brow lamination?*
  • Do you have permanent eye or brow makeup?*
  • Do you wear contact lenses?*
  • If yes, do you agree to remove them for the procedure?*
  • Do you currently have any other lash or brow procedures? (Lash extensions, etc)*
  • I give permission to the lash technician to perform the following procedures:*

  • I completed the above form to the best of my knowledge. I have had the opportunity to ask any questions and have received satisfactory answers. I will inform the technician of any changes to the above information. I will not hold the technician, salon, or employees liable for any issues not disclosed at the time of my service or any adverse effects from the lash lift, brow lamination and/or tint procedure.

  • Date*
     / /

  • THE EYELASH LIFT AND TINT, AND THE BROW LAMINATION PROCEDURES ARE PERFORMED WITH THE PROPER TECHNIQUE, PRODUCTS, AND INSTRUMENTS, AND WITH YOUR SAFETY IN MIND. HOWEVER, THERE STILL ARE SOME RISKS ASSOCIATED WITH THE PROCEDURE(S THIS CONSENT FORM IS INTENDED TO INFORM YOU OF THE RISKS OF THE PROCEDURE(S) AND TO OBTAIN YOUR INFORMED CONSENT FOR THE PROCEDURE(S).

     

  • Date*
     / /
  • Should be Empty: