EYELASH EXTENSIONS
I authorize Llumier Wellness to apply Eye Lash Extensions.
I understand that there is a possibility for a reaction to the lash adhesive which may happen to some unfortunate individual. Llumier Wellness has no control over it, since cyanoacrylate is an ingredient used in all eyelash adhesive, even those formulated for sensitive or allergic eyes.
You are invited to schedule a patch test with your Llumier Wellness Lash Specialist at least one day before the actual lash appointment in order to test if you may have an allergic reaction. Please contact us directly to schedule your sensitivity test. If it turns out that you are allergic to one lash adhesive, you will most likely be allergic to all lash extension adhesives, since all contain cyanoacrylate (only the level of concentration differs). For those unfortunate client, we will not offer refund but will offer free removal.
I understand that it is my responsibility to be still during the procedure and to keep my eyes closed during the process unless otherwise advised. I have been fully informed as to the methods and procedures concerning the eye lash extension procedure. The risks of the cosmetic procedure I have chosen have been disclosed to me.
If at any time I (or the technician) are uncomfortable with the procedure, I will inform the technician and s/he will gladly rectify the problem, including ending the session if I (or the technician) wish. It has been represented to me that no guarantees, warranties, promises, commitments or other statements as to the results of this treatment have been made. I acknowledge that I have no particular representation or guarantees, and I am consenting to the procedure at my own risk.
All conditions must be revealed or disclosed by me to the technician regarding my health history, medications being taken and any past reactions to products used or medications taken. Additional conditions could be discovered during the procedure, which could a ect my ability to tolerate the procedure.
I herein signed, release, give up, acquit, and discharge my Llumier Wellness professional and or anyone a iliated there to including any partnership, corporations, or company associated with said individual from any claims or damages of any nature. I agree to pay any costs of legal services necessary to a ect said release. I further agree that this release shall be in contemplation of any possible damages, either known or unknown at the signing of this release and said damages are specifically waived following the signing of this release. I further agree that in the event any litigation ensues, it shall be placed before the American Arbitration Association or some other such arbitrator for resolution. I agree that in the event a decision is determined in favor of one party over the other, the prevailing party shall be entitled to reasonable attorney fees and costs as set by the arbitrator. I further agree to hold my Llumier Wellness professional nameless and harmless from any and all damages. I release my Llumier Wellness professional from any responsibility for pre-existing conditions I have not revealed or any consequential change to those conditions that arise subsequent to the procedure. I accept full responsibility for these and any other complications, which may arise or result during or following the eye lash extension procedure(s), which are to be performed at my request.
I, the client herein signed, certify that I have read and fully understand the above waiver and release form. I have provided information regarding my health and medications taken to the best of my knowledge. I accept the explanation of potential complications and risks described herein. I certify I am of sound mind, and fully understand that there might be other unknown risks not reasonably foreseeable at this time.