Brow Lamination & Lash Lift / Tint Consent & Release Form

Brow Lamination & Lash Lift / Tint Consent & Release Form
Client Information
Name

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Date of Appointment

MonthDayYear
Date
Brow LaminationBrow TintLash LiftLash Tint
Service Descriptions

Brow Lamination is a professional treatment that softens and restructures brow hairs to create a fuller, lifted, and more uniform appearance. Results typically last 4–8 weeks.

Lash Lift & Tint enhances the natural lashes by lifting and curling them from the base and, when included, tinting them darker for definition. Results typically last 6–8 weeks.

Results vary based on hair type, growth cycle, aftercare, and lifestyle factors and are not guaranteed.
Contraindications & Medical Disclosure

Please answer YES or leave blank for NO to each statement:
I am currently pregnant or breastfeedingI have eczema, psoriasis, dermatitis, or active skin irritation near the brows or eyesI have broken skin, cuts, sores, sunburn, swelling, or healing wounds in the brow or eye areaI have used Accutane (Isotretinoin) within the past 12 monthsI have used retinoids, tretinoin, adapalene, benzoyl peroxide, or exfoliating acids near the brow or eye area within the past 7 dayI have had a chemical peel, laser treatment, microneedling, brow lamination, or lash lift within the past 4 weeksI have had allergic reactions to hair dyes, perms, lash, or brow productsI have had recent eye surgery, eye infections, chronic dry eye, or eye conditions requiring medical treatment
If you answered YES to any of the above, your service may be modified, postponed, or declined for safety reasons.
Possible Risks & Side Effects
I understand that brow lamination, lash lift, and tint services may cause temporary side effects including but not limited to:

Redness, irritation, itching, swelling, or watering of the eyes
Sensitivity or tenderness in the treated area
Dryness or brittleness of brow or lash hairs if aftercare is not followed
Rare allergic reactions

I understand that results vary and no specific outcome can be guaranteed.
Signature
Aftercare Acknowledgement
I understand and agree to follow all aftercare instructions provided, including but not limited to:

Keeping brows and lashes dry for 24 hours
Avoiding steam, heat, saunas, swimming, and excessive sweating
Avoiding eye makeup, lash serums, retinoids, exfoliating acids, and active skincare products near the treated area
Using recommended conditioning or nourishing products

I understand that failure to follow aftercare instructions may affect results, longevity, and hair integrity.
Signature
Consent & Liability Release
I confirm that all information provided is accurate and complete to the best of my knowledge. I understand the procedures, risks, and expected outcomes of brow lamination, lash lift, and tint services. I voluntarily consent to receive these services from Goddess Esthetics and release the business and service provider from liability associated with these treatments.
Signature
Photo & Media Release
I authorize Goddess Esthetics to take before-and-after photos or videos for education, marketing, and social media purposes. No identifying personal information will be shared.
Signature
Signature

Please sign acknowledging the above to be true
Date

MonthDayYear
Date
Signature
Should be Empty:

Brow Lamination & Lash Lift / Tint Consent & Release Form

Client Information

Contraindications & Medical Disclosure

Possible Risks & Side Effects

Aftercare Acknowledgement

Consent & Liability Release

Photo & Media Release

Signature