1. Risks & Possible Side Effects
I understand there are risks associated with having eyelash extensions applied and/or removed, including but not limited to:eye irritation, discomfort, itching, redness, swelling, allergic reactions to adhesive or products, damage to natural lashes, or infection; in extremely rare cases, severe allergic reaction, temporary or permanent damage to eyesight (including blindness), vision changes, or scarring.
I understand that individual results vary, and there are no guarantees regarding how long the extensions will last or how my natural lashes may respond.
2. Medical Conditions & Disclosure
I confirm that I have disclosed all known allergies, skin sensitivities, eye conditions, medications, and medical concerns that may interfere with or increase the risks of this procedure. I confirm that I do not currently have conditions such as blepharitis, conjunctivitis, styes, eye infections, or other medical issues that may make this procedure unsafe.I understand that failing to disclose medical conditions, allergies, or medications is my responsibility and may increase risks. I agree to notify my technician of any health changes before future appointments.
3. Illness & Contagious Conditions
I confirm that I am not currently experiencing symptoms of contagious illness, including but not limited to: fever, cough, eye infection, cold, flu, or COVID-19.
I understand that services may be refused or rescheduled if I show signs of illness, for the health and safety of both client and technician.
4. Procedure Conditions
I understand I will be required to lie still with my eyes closed for 60–180 minutes during the procedure. If I have a medical condition that prevents me from doing so, I may not be able to undergo this procedure. I understand that adhesive fumes and tools used during the procedure may cause temporary discomfort.
5. Aftercare Responsibility
I understand and agree to follow the aftercare instructions provided by my technician. I understand that failure to follow aftercare instructions may cause poor retention, irritation, or premature lash loss. I understand that maintenance (lash fills) are required to keep extensions looking full.
6. No Guarantees
I understand there are no guarantees or warranties as to results, bonding time, or retention of lash extensions. I understand that natural lash growth cycles and personal lifestyle habits will affect how long extensions last. I understand that fees paid are for services rendered and are non-refundable.
7. Release of Liability
I release, discharge, and hold harmless Arlena Parker, Holistic Glow Electrology and Wellness, its owners, technicians, and employees from any and all claims, damages, demands, or causes of action related to this procedure, including but not limited to allergic reactions, eye irritation, infection, loss of natural lashes, temporary or permanent vision damage, or any other consequences. I understand this release applies to this procedure and to all future eyelash extension procedures performed by Arlena Parker, Holistic Glow Electrology and Wellness. I understand this waiver is intended to be interpreted as broadly as permitted under California law, and if any portion is found invalid, the remainder shall still be enforceable. I understand that this waiver does not release Arlena Parker, Holistic Glow Electrology and Wellness from liability for gross negligence or unlawful conduct.
8. Age Confirmation
I confirm that I am at least 18 years old.
If under 18, a parent or legal guardian must sign below to provide consent.
9. Photography & Media
I consent to photos or videos of my lashes being taken and used for educational, marketing, or promotional purposes.
Acknowledgment
I have read and fully understand this waiver. By signing below, I voluntarily accept all risks associated with eyelash extension services and release Arlena Parker, Holistic Glow Electrology and Wellness from liability as described above.