Lex Lashed Consent and Intake Form

I   First Name*Last Name*   agree to have eyelash extensions, or a lash lift and tint applied to my natural eyelashes and/or removed and retouched. By signing this agreement, I consent to having the service(s) done by the licensed esthetician/certified lash professional (Lex Lashed).  

*I release Lex Lashed from any and all liability associated with the above mentioned procedure(s). I understand that the service will be performed with the utmost attention to safety, sanitation, and proper application using tools and products that the esthetician has been trained and certified to use.

 Initial*   I understand that in rare occasions there are risks associated with having a lash lift and tint, or artificial eyelashes/eyelash extensions, applied to or removed from my natural eyelashes. I further understand that in rare cases as part of the procedure eye irritation and discomfort or allergic reaction could occur. If any reaction(s) occur, including those mentioned above, Lex Lashed is not liable, and will not issue a refund for the service.

 Initial*   I understand and agree to the aftercare instructions provided by the Lex Lashed for the use and care of my eyelash extensions, or lash lift and tint. I realize and accept the consequences of failing to adhere to these instructions may cause the eyelash extensions to prematurely fall out, and/or impact the retention of the lashes, and/or cause damage to the natural lashes. I also understand not following proper aftercare could result in infection.   

Initial*   I understand and consent to having my eyes closed for the duration of the service process for my safety. Times vary depending on the service.

* Eyelash extensions require on-going maintenance (similar to getting your nails done). Refills are recommended every 2-3 weeks depending on your personal retention. I understand that if I go beyond the recommended fill times it may result in an incur (higher) service cost as a full-set. 

 Initial*   I agree to inform the certified lash professional of the following at time of service:
• Current use of contact lenses, which I may be asked to remove during the procedure. (To avoid having to remove contact please come with glasses on instead.)
• Current use of anything such as oil-containing sunscreen, moisturizers, or makeup around the eyes, which I may be asked to remove for the procedure. 

*   I am 18 years of age or older and consent to the agreement and to the lash service procedure. If I am under the age of 18 I agree to bring a parent or legal guardian to my first appointment to fill out a physical consent form giving Lex Lashed permission to perform the procedure and all future procedures.

  Initial*   This agreement will remain in effect for this procedure and all future follow–up appointments conducted by the licensed esthetician (Lex Lashed). I have read all of Lex Lashed policies listed on provided on the business’ website (https://lex-lashed.square.site/policies) and hereby agree to abide by policies upon signing and submitting this form. I agree that policies are subject to change and if I have a concern I will consult Lex Lashed prior to my appointment. I have read this consent form in English and understand that once signed and submitted this consent agreement is legal and binding. I have read the form in its entirety and fully understand all information in this agreement.