EYELASH EXTENSION WAIVER
I agree to have eyelash extensions applied to my natural eyelashes and/or removed and retouched. I consent to the placement and/or removal of the eyelash extensions by the certified eyelash extension professional.
I understand that in rare occasions there are risks associated with having artificial eyelashes and 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 could occur. I agree that if I experience any of these conditions with my lashes that I will contact the certified eyelash extension professional that performed this procedure and it may be beneficial to have the eyelashes removed.
I understand and agree to the after-care instructions provided by the certified eyelash extension professional for the use and care of my eyelash extensions. I realize and accept the consequences of failure to adhere to these instructions may cause the eyelash extensions to fall out and/or decrease the time the lashes will last.
I understand and consent to having my eyes closed and covered for the duration of approximately 60-120 minute procedure. Times may vary depending on the type and number of eyelashes applied.
I am informing the certified eyelash extension professional of the following conditions by marking with a check: ☐ Current use of contact lenses which I may be asked to remove during the procedure ☐ Current use of anything such as oil-containing sunscreen or moisturizers around the eyes ☐ Current use of eye drops of any kind, prescription or over-the-counter ☐ Current allergies or sensitivities ☐ History of recurrent eye or tear duct infections ☐ History of dry eyes or Sjorgen’s Syndrome ☐ Recent history of Chemotherapy ☐ Other medical conditions which would prohibit or compromise placement and retention of eyelash extensions ☐I agree to the following eyelash extension follow-up and maintenance instructions: ☐ No waterproof mascara ☐ No oil based products around the eye area ☐ No water can come in contact with the eye area for 24 hours after the application ☐ No tinting or perming of eyelash extensions ☐ No pulling or rubbing of the eyelash extensions ☐ Should any kind of eye drops be necessary extra care should be taken to prevent moisture from coming into contact with the eyelash extensions.
I understand due to the nature of the services there are no refunds, a grace period of 3 days is available should there be any issues with the extensions. Any time after the 3 day period I understand I will be responsible for any fill / touch-up costs.
This agreement will remain in effect for this procedure and all future follow-ups conducted by the certified eyelash extension professional. I read English and understand that this consent agreement is legal and binding. I have read and fully understand all information in this agreement. I am over 18 years of age and consent to the agreement and to the eyelash extension application procedure.