Lash Lift/Tint Intake and Consent Form

I understand that this procedure requires lifting solution and/or tint applied to my own natural eyelashes, and it is my responsibility to keep my eyes closed and be still during the entire procedure. Please no small children or pets.

I am informed of potentially harmful or negative side effects that may be caused by the application or removal and release the Technician from all liability associated with this procedure.

I understand that some risks of this procedure may result in, but not limited to, eye redness and irritation. The products used may release fumes and can cause my eyes to water.

I agree to disclose medical conditions including skin conditions and/or any allergies that I may have to latex, surgical tapes, cyanoacrylate, etc.

If yes, please list here:

During the first 24 hours following every lash procedure/application, I agree to avoid: wetting the lashes, swimming, pools, steam from showers, saunas and tanning beds. I will follow the aftercare instructions given to me.

I understand that a deposit (30% of service) may be required for booking (non-refundable) and is subject to change at any time. No refunds will be issued on services, exchanges will be made on defective items only.

If I need to cancel any of my appointments, I will inform you ASAP. I will forfeit my deposit if I give less than a 24-hr. notice, and/or agree to pay a rescheduling fee (50% of service) or if no call/no-show (100% of service) if spot can't be filled.

If I am more than 15 minutes late, I understand my appointment may need to be rescheduled and will be subject to the no-show fee above.

YesNo

Phone/TextEmail

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Email

example@example.com

I understand Me Time Sanctuary reserves the right to refuse service to anyone at any time for any reason.

Date

Client Name*

Client Signature*

Parent/Guardian Name (if under 18 years):

Parent/Guardian Signature

*Note: Your privacy is important to us. We will not sell or share your personal information with third parties, unless required by law.