Lash Lift & Tint Consultation Form
Location
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SEBRING - 121 S COMMERCE AVE SEBRING, FL 33870
MIAMI - 8500 W FLAGLER STSUITE 106AMIAMI, FL 33144
Name
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First Name
Last Name
Phone Number
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Please enter a valid phone number.
Email
*
example@example.com
Date of Service
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Month
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Day
Year
Date
Do you have any of the following contraindicated conditions?
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Allergies to adhesive tape, fumes or eye remover
Dry Eye Syndrome
Sjorgen's Syndrome
Currently having Chemotherapy
Ocular Rosacea
None
Are you 18 years old or older? If no, you please have a parent or guardian submit a Waiver for Minors.
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Yes
No
I consent to having my eyes closed and covered for the duration of the 60-75 minute procedure.
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Yes
No
Do you wear contacts? If so, please bring your storing case to remove them for the session.
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Yes
No
Liability Release
I consent to the waxing services provided by MONT. ESTHETICS, LLC. (referred to as "The Esthetician". I agree to have an eyelash lift (perm) and/or eyelash tint applied to my natural eyelashes and/or retouched. By signing this agreement, I consent to the procedure of an eyelash perm or eyelash tint by my technician.I understand there are risks associated with having an eyelash perm and/or eyelash tint. I further understand that as part of the procedure, eye irritation, eye pain, eye itching, discomfort, and in rare cases eye infection or blurriness could occur. I agree that if I experience any of these medical conditions with my lashes that I will contact my technician and consult a physician at my own expense.I understand that even though my technician perms the lashes using the proper technique, the instruments, tapes, cleaners, eye gel pads, adhesives, and removers used may irritate my eyes or require a physician’s follow-up care.I understand and agree to the care instructions provided by my technician for the use and care of my permed and/or tinted eyelashes. I realize and accept the consequences of failure to adhere to these instructions may cause the eyelashes to not stay permed as long as told.I agree as post-lash lift that no water can come in contact with the eye area for 24 hours after the application and I avoid using oil containing sunscreens, moisturizers and cleansers of on lashes.This agreement will remain in effect for this procedure and all future procedures conducted by my technician. I read English and understand that this consent agreement is legal and binding. I understand is performed with the utmost attention to safety and proper application using tools and products that the technician has been professionally trained to use. There are no guarantees for length of time the lashes will stay permed. I understand the aftercare instructions and will do my part to maintain my eyelashes. I understand that there are many factors that may affect the life of the eyelash lift such as water and moisture contact, weather conditions, and activities involving exposure to high temperatures.The Esthetician reserves the right to refuse service for any reason deemed appropriate, including but not limited to behavior that is disruptive, disrespectful, or poses a risk to the safety and well-being of staff and other clients.I release MONT. ESTHETICS, LLC. from all liability associated with this procedure. There are no guarantees for the bonding time length of the eyelash extensions. I understand that I have been advised to follow the aftercare protocol from my technician to avoid any discomfort or aderse side effects after the procedure has been completed.I acknowledge that I confirm I am either at least 18 years old or accompanied by a legal guardian & I have read, understood, and agreed to the terms and conditions outlined in this Agreement.
POLICIES SEBRING
BOOKING AGREEMENT (SEBRING)
MONT. ESTHETICS, LLC. requires a Credit Card on file for all booked appointments (YOUR CARD WILL NOT BE CHARGED UPON BOOKING.) If booking online, there is no deposit required. If booking directly through me (text, dm, etc.) a non-refundable deposit of 50% of service costs is required. Deposit must be sent VIA: Cashapp $MONTESTHETICS and will go towards service costs. The remainder of the service costs must be paid via debit/credit, cash, or cash app on the day of the service. Deposit must be made within 24 hours of booking or the appointment will be canceled. No credit card/deposit = no appointment
CANCELLATION POLICY (SEBRING)
Please cancel/reschedule your appointment AT MOST 12 hours before your scheduled appointment. Anything less will result in a fee of 100% of service costs. The card on file will be charged. To avoid a fee, you may reschedule past the grace period, only valid one time per appointment and no more than 7 days from the initial appointment. If rescheduling within the grace period, there is no fee.
LATE (SEBRING)
All appointments are granted a 10-minute grace period. Anything late beyond 10 minutes will result in cancellation. No time will be added to your appointment if you are late within the grace period. The service MUST have begun at the exact 10-minute mark, if you are just arriving by the 10-minute mark the appointment will be canceled. 50% of the service cost will be charged to the card on file. If time allows, OR if rescheduling, the fee is waived.
NO-SHOWS (SEBRING)
All no-shows will result in a no-show fee. Fee equals 100% of service costs. The card on file will be charged. Rescheduling is available at this point with a new 50% deposit. No-call-no-shows will be banned from booking any future appointments.
NO MAKEUP (SEBRING)
Please refrain from wearing makeup to your appointments to keep the appointment at its allotted time.
AFTERCARE (SEBRING)
Aftercare instructions and tips are thoroughly explained after your service. It is crucial to follow the steps provided to you to maintain proper retention and lash health.
GUESTS (SEBRING)
Guests are allowed and must sit in the waiting room.
NO CAFFEINE (SEBRING)
Please do not drink ANY caffeinated drinks on the day of your appointment.
HEALTH (SEBRING)
When booking, you confirm that you are not sick or experiencing COVID-19/Flu/Cold-like symptoms. If you have any medical conditions or are currently taking any medications, you must speak that to your lash artist (medical conditions/medications can affect retention by increasing your average amount of hair loss.)
POLICIES MIAMI
BOOKING AGREEMENT (MIAMI)
Appointments with MONT. ESTHETICS, LLC. must be made online. MONT. ESTHETICS, LLC. requires a full service payment upon booking to secure your appointment. Refunds are granted if canceling within the grace period. Partial payment will not be accepted. No payment = no appointment.
CANCELLATION POLICY (MIAMI)
Please cancel/reschedule your appointment AT MOST 24 hours before your scheduled appointment. Anything less will result in the TOTAL loss of your payment. If rescheduling within the period of my pop-up visit, the fee is waived (valid 1x per appt. and only if availability allows.)
LATE (MIAMI)
All appointments are granted a 10-minute grace period. Anything late beyond 10 minutes will result in cancellation and TOTAL loss of your payment. If time allows OR if rescheduling within the pop-up visit, this policy will be waived.
NO-SHOWS (MIAMI)
All no-shows will result in the TOTAL loss of your payment (refund will not be granted.) Rescheduling is available at this point with a new payment. No-call-no-shows will be banned from booking any future appointments.
NO MAKEUP (MIAMI)
Please refrain from wearing makeup to your appointments to keep the appointment at its allotted time.
AFTERCARE (MIAMI)
Aftercare instructions and tips are thoroughly explained after your service. It is crucial to follow the steps provided to you to maintain proper retention and lash health.
GUESTS (MIAMI)
Guests are allowed and must sit in the waiting room.
NO CAFFEINE (MIAMI)
Please do not drink ANY caffeinated drinks on the day of your appointment.
HEALTH (MIAMI)
When booking, you confirm that you are not sick or experiencing COVID-19/Flu/Cold-like symptoms. If you have any medical conditions or are currently taking any medications, you must speak that to your lash artist (medical conditions/medications can affect retention by increasing your average amount of hair loss.)
Signature
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