Lash Extension Consent Form

I agree to have eyelash extensions applied to my natural eyelashes. By signing this agreement, I consent to the procedure of eyelash extensions by my technician.   I understand there are risks associated with the eyelash extension application procedure. I further understand that as part of the procedure, eye irritation, eye pain, eye itching, discomfort, stinging or burning, 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 applies lash extensions using the proper technique, the instruments, tapes, cleansers, under eye gel pads, adhesives, and/or 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 eyelash extensions. I realize and accept the consequences of failure to adhere to these instructions, which may directly affect the retention and the overall appearance of my lash extensions, and may cause me to require fills more often than I was told. I understand that I lose natural lashes at a rate of 1-5 lashes per day, and I will need to return for fills on a regular basis to maintain my desired look. I realize that getting my lashes wet within 24 hours after application may compromise the bond of the adhesive and reduce my retention. I also realize that traveling to areas with different humidity levels, temperatures, air quality, and other factors may have alternative effects on my lashes and may require extra care while I?m away in order to maintain the quality of my lashes. I agree to use only oil-free products on my lashes and to keep my lashes clean for optimum retention.   I understand and consent to having my eyes closed for the duration of the procedure, which is 30-60 minutes for a fill and up to 105 minutes for a full new set.
1. Check all that apply:
2. If yes to allergies please list, any other medical conditions list here:
By signing below, I verify that I have read and understand the above statements and agree to them.