Customer Consent Form

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Client Information

How did you hear about us?
Is this your first time you have / had eyelash extensions?
Do you
Are you having your lash extensions applied for
Do you habitually rub, pull or pick your lashes for any reason?
Do you have or are you being treated for any eye illness or injury?
Are you able to keep your eye's closed and lie still for up to 2 hours or longer?
Please check off any of the following that might apply to you

Client Notes

I agree to the following
I understand there are risks associated with having artificial eyelashes applied to and / or removed from my natural eyelashes. I understand that the eyelash extensions will be applied to the natural lash as determined by the technician so as not to create excessive weight on the natural eyelash thereby preserving the health, growth, and natural look of the client's natural eyelashes. I understand as part of the procedure eye irritation, eye pain, eye itching, discomfort and in rare cases eye infection may occur. I understand and agree that if I experience any of these issues with my lashes that I will contact my technician and have to remove eyelashes immediately and consult a physician at my own expense. I understand that even though my technician may apply and remove the eyelash properly, that adhesive materials may become dislodged during or after the procedure. I understand and agree to follow the after care instructions provided by the technician. Failure to follow the after care instructions can cause the eyelash to fall off. I understand in order to have the eyelash extensions applied to my eyelashes I will need to keep my eye closes for 60-100 minutes during the procedure. I also need to understand that I will be lying down on a reclined position. This agreement will remain in effect of the procedure and all future procedures conducted by my technician from one year from the date of this form is signed. I understand that this agreement is binding and that I have read and understand all the information listed above.