Korean Lash Lift
Customer Details:
Full Name
*
First Name
Last Name
Phone Number
*
Format: (000) 000-0000.
E-mail
example@example.com
Health and Medical Disclosure
Sensitive Eyes
Dry Eyes
Watery Eyes
Allergies (cosmetic, seasonal, adhesive)
Eye infection (current or recent)
Recent Eye Surgery
Eczema
Pregnant
Using Lash Serums
Contact Lens wearer
If yes, explain
Contraindications
I understand I am not a candidate for this service if I have the following: active eye infections/irritation, open wounds/cuts, recent eye surgery without medical clearance, severe sensitivity.
Risks and Acknowledgment
I understand that although rare, the following may occur: eye redness/irritation, allergic reaction, dryness, uneven results due to lash condition.
Aftercare Agreement: I agree to follow proper aftercare instructions including:
Avoid water, steam, sweat for 24 hours
No rubbing/pulling lashes
Avoid oil-based products near the eyes
Brush lashes daily
I understand that failure to follow aftercare may affect results.
Liability Waiver
I voluntarily consent to the Korean Lash Lift service. I release aizesthetics and the esthetician from liability for any adverse reactions that may occur, provided all procedures are performed correctly and professionally.
Signature
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