• Lash Extension Client Liability Waiver

  • Format: (000) 000-0000.
  • Date of Birth*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Is this your first time getting lash extensions?*
  • Are you having lash extensions applied for?*
  • Do you wear contacts?*
  • Are you pregnant?*
  • Are you able to lay on your back for 2+ hours to have your lashes applied?*
  • Will you able to keep your eyes completely closed for 2+ hours ?*
  • Do you have, or are you being treated for any eye illness or injury?*
  • How do you usually sleep? Please note you will lose more eyelash extensions on the side on which you sleep. Sleeping on your stomach will affect them the most and it is important to refrain from sleeping on your stomach for the first 4 days after your service to allow the adhesive to set properly.
  • I, undersigned, agree with the following statements:*
  • THE FOLLOWING CONDITIONS ARE NOT SUITABLE FOR EYELASH EXTENSIONS POSSIBLE ADVERSE REACTIONS ARE LISTED BEOW EACH CONDITION. 

  • Are you allergic to adhesives ( glues, tapes, band aids, etc)? This service may use adhesives tapes, glues and gel pads thaty may cause an allergic reaction. We use a medical grade, formaldehyde free glue, but allergies may still occur.? *
  • Have you had Lasik Surgery in the past 4 months? Eyes may have sensitivity to eyelash extensions and products used for prepping the eye area (gel pads, glues, etc.).*
  • Do you wear Contact Lenses:Contact Lenses MUST be removed prior to eyelash extensions procedures. Products may get underneath the contact lens and cause an abrasion or scratching. *
  • Do you have Extremely Oily skin and or hair? Natural oils will break down the adhesives used to bond the eyelash extensions causing the extensions to fall out quicker. This does not mean you cannot have the service, merely it may cause them to fall out faster.*
  • BEAUTIFUL LASHES CAN BE A SERIOUS CONFIDENT BOOST! HERES WHAT YOU WILL EXPERIENCE TODAY.

  • Step 1 - Consultation with your Lash Extension Expert to insure this service is right for you and explain to your before, during and after experience thoroughly.
    Step 2 - Select the style of lashes you would like, to cover length, fullness and shape!
    If you’re unsure, your lash tech will be happy to recommend what’s best for you and your lifestyle.
    Step 3 - Get Lashed Up!
    Step 4 - Rebook for your refill in approx 2 to 3 week.
    Just a few more things! This is to insure a great service and outcome for you

  • Please sign that you are aware that specialist has sanitized hands and implements. I assume full responsibility for myself and anybody in my care. I have notified my eyelash specialist of any and all health complications that I may have, and have provided said specialist with a list of my medications and allergies. I will give a minimum of 36-48 hours notice for a cancellation so that specialist can book another client for the time that was reserved. If I don’t not give 24 hours notice for a cancellation or rescheduling, l will pay a fee of 60% to compensate for the specialist’s time, If I cancel or reschedule 4 hours before my appointment, I will pay a 75% cancellation fee to compensate specialist for their time, If I do not call to cancel an appointment and fail to show up to said appointment, then I am aware that I will be charged up to a 75% fee of the service. I am aware that on rare occasions, an allergy may occur between myself and the lash adhesive, where irritation, redness, or swelling may take place. If this should happen, I will not hold the specialist who applied my eyelash extensions liable. I have reviewed my original Client Intake Information Form and confirm that I have disclosed all accurate information to the best of my ability. I also have the right to request a copy of my Client Awareness Form. For any and every additional eyelash extension appointment I will review these forms and either confirm that the information is still up to date,or I will make my lash technician aware of any changes. I understand that to insure the longest lasting lashes possible, I should avoid rubbing and pulling on my eyelashes. I understand that mascara of any kind could break down the lash adhesive, resulting in a shortened lash life. I am aware that the lash adhesive needs at least 24-48 hours to fully cure and that I MUST avoid water, steam, tears, eye drops, or any wet products in, on, or around my eyes and lashes during this time period. I am fully aware that moisture on my lashes within 24-48 hours after my eyelash extensions have been applied may result in irritation to my eyes or eyelids and could compromise the appearance and/or the longevity of the lashes. I understand that any products, such as makeup removers, moisturizers, make-up, or eye creams, on or around my eyelashextunsions may compromise the longevity of the lashes, If i fail to follow these
    after care instructions. I will not render my eyelash specialist or Jazmyn Mata
    responsible for any dissatisfactory results

  • Date*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Should be Empty: