Lash Extension Consent Form✨
Name
First Name
Last Name
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Do you have any allergies? If so, specify:
Have you previously had Lash Extensions?
Yes I have!
It’s been awhile…
No, it’s my first time!
Do you wear eye contacts? If so please remove them,Thank you!
Yes
No
Are you pregnant?
Yes
No
Do you have watery or sensitive eyes?
Yes
No
Consent
I, [Client's Name], hereby consent to the application of eyelash extensions by Lashesbymichi. I understand and acknowledge the following: Purpose of Lash Extensions: I understand that eyelash extensions are applied to enhance the length, thickness, and curl of natural eyelashes for aesthetic purposes. Procedure Description: I understand that the lash extension procedure involves the careful application of individual synthetic or mink lashes to each natural eyelash using a specialized adhesive. The procedure may take up to 3 hours to complete, depending on the desired look and number of lashes applied. Potential Risks and Side Effects: I acknowledge that there are inherent risks associated with the application of lash extensions, including but not limited to:Irritation or allergic reactions to lash extension adhesive or materials.Discomfort or sensitivity during or after the procedure.Damage to natural eyelashes, including breakage or premature shedding.Eye irritation or infection if proper hygiene practices are not followed.Allergic reactions to lash extension adhesive or materials. Maintenance and Aftercare: I understand that proper aftercare is essential to maintaining the appearance and longevity of lash extensions. I agree to follow the aftercare instructions provided by the lash tech, including avoiding contact with water, oil-based products, and rubbing or pulling on the lashes. Informed Consent: I have been provided with information about the lash extension procedure, including the potential risks, side effects, and aftercare instructions. I have had the opportunity to ask questions and have received satisfactory answers. Medical History: I have disclosed any relevant medical conditions, allergies, or medications that may affect my eligibility for lash extensions. I understand that it is my responsibility to inform the lash tech of any changes to my medical history or medications before each lash extension appointment. Release of Liability: I release Lashesbymichi from any liability arising from the application of lash extensions, including but not limited to allergic reactions, injuries, or dissatisfaction with the results. By signing below, I acknowledge that I have read and understood the contents of this Lash Extension Consent Form, and I voluntarily consent to the application of lash extensions.
Please Agree To Terms & Conditions
I am fully aware my appointment will be canceled after 10-15 minutes. After 10 minutes I will be charged a $10 late fee if my lash tech is available to take me in. I am aware and give full consent to be charged any fees that are required including dirty lashes fee, cancellation fee, no show fee and late fee.
I am 100% aware my service & deposit is non-refundable.
I am aware of NO EXTRA GUESTS
I will not reveal my technicians personal life/info
I understand I will be kicked out or ban from booking if I have disrespected the policies or my technician
I am fully aware that I will pay in full at my appointment and know the price I am paying. NO REFUNDS
I acknowledge that I understand and agree to the aftercare instructions, and accept responsibility for any unforeseenconsequences that could happen from failing to follow them.
I am aware that there are a few unusual risks associated with wearing eyelash extensions, such as the possibility of skin and eye irritation and pain.
Signature
Date Signed
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Month
-
Day
Year
Date
Submit
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