Korean Lash Lift Consent Form
Please read the following consent form carefully before proceeding with your lash lift treatment.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Have you had any allergic reactions to perm solutions, tints, or adhesives?
*
Please Select
yes
no
Do you currently have eye infections, irritations or conditions?
*
Please Select
yes
no
Are you using any eye drops, lash serums, or medications that affect hair growth?
Please Select
yes
no
Are you wearing contact lenses today? If so, it is recommended they be removed before the service.
Please Select
yes
no
Are you currently pregnant or breastfeeding?
*
Please Select
yes, breastfeeding
yes, pregnant
no
By signing below you understand the following:
I understand that results may vary depending on natural lash growth and length.
I understand that no refunds will be made after service is done.
I agree to be recorded/taken photos of for marketing and social media use. (don’t check here if not comfortable)
I release the technician from any liability related to allergic reactions etc.
Please confirm that you understand the following and agree to proceed with the lash lift treatment. By signing below, you acknowledge that you have been informed about the procedure, potential risks, and aftercare instructions. Signature
*
I Agree and Submit
I Agree and Submit
Should be Empty: