Brow Lamination & Lash Lift Form

*Signature + Completed Form is Required for Service*
Please fill out & sign all forms prior to or before the time of your appointment.

Name*

FirstLast

Address*

Street Address

Street Address Line 2

CityState

Email*

example@example.com

Phone Number*

Date of Birth*

(for birthday goodies)

How did you hear about us?*

If referred, who referred you?

Referrals both receive $10 off services.

Have you previously received a lash lift or brow lamination before?*

YesNo

Do you have any known allergies to perm solutions, hair dyes, acrylates or cyanoacrylates?*

YesNoNot sure

Do you wish to waive a free patch test?*

WaiveI want a free patch test

These procedures are NOT recommended if you have any of the following. Please check any and all that applies to you:*

I understand:*

A brow lamination and/or lash lift is a semi-permanent chemical procedure of reconstructing or "perming" the hairs to keep them in a desired shape however, it is my own responsibility to brush them daily to achieve the desired look.Although not guaranteed, results from procedures may last 4-8 weeks; differs based on hair and skin types, and lifestyle.Experiencing some redness or mild sensitivity of the skin is normal.Despite the use of the most advanced and high-quality products and ingredients, an allergic reaction is possible.As part of the procedure, skin/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 or brows, I will contact my stylist and if necessary, consult a physician at my own expense.My stylist will take every precaution to minimize or eliminate negative reactions as much as possible. In the event I may have additional questions or concerns regarding my treatment, I will consult her immediately.It is my responsibility to advise the stylist of any concerns I may have before these procedures.

Aftercare
By signing below, I agree to follow all aftercare instructions given to me by my stylist to ensure proper and sufficient healing process to achieve the best results.

I understand that if I have any concerns, I will address them with my stylist. I give permission to my stylist, Sophia Luong, to perform the said procedures we have discussed, and will hold her harmless and nameless from any liability that may result from this treatment.

Photography
By signing below, I consent to photos being taken before and after treatments for client notes and documentation that may be used on social media however, client privacy is important to us and any photo used will be cropped appropriately if required.

LIABILITY RELEASE AGREEMENT

I understand that if I have any concerns, I will address them with my stylist and cosmetologist. I give permission to my sylist, Sophia Luong, to perform the procedures we have discussed, and will hold her harmless and nameless from any liability that may result from this treatment.

I understand my stylist will take every precaution to minimize or eliminate negative reactions as much as possible. In the event I may have additional questions or concerns regarding my treatment, I will consult the stylist immediately.

I agree that this constitutes full disclosure, and that it supersedes any previous verbal or written disclosures.

I do not hold the stylist or SOLUXBeauty LLC., responsible for any of my conditions that were present, but not disclosed at the time of this procedure, which may be affected by the treatment performed today.

I certify that I have read, and fully understand, the above paragraphs and that I have had sufficient opportunity for discussion to have any questions answered. I understand the procedure and accept the risks.

I have read and agree to all the terms above.*

I agree.

Today's Date*

Signing Date

Signature *

By signing, you agree to all terms and conditions.

Brow Lamination & Lash Lift Form

Medical History

Consent & Release

Thank you for submitting, service you soon!