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Eyelash Extension Consent

Name

Phone Number

Appointment

Health History

Had Eyelash Extension

YES NO

By signing this appointment and consent form, I, hereby, acknowledge, consent, and agree to all of the following:

I have read and understood the instructions above.
The eyelash extension procedure requires synthetic eyelashes to be glued to my own natural eyelashes.
it is my responsibility to keep my eyes closed and be still during the entire procedure until the technician leads me to do the opposite.
There are some risks of this procedure may be but not limited to eye redness and irritation. The fumes from the adhesive may cause my eyes to tear up if I do not keep my eyes closed.
There are some risks of this procedure may be but not limited to eye redness and irritation. The fumes from the adhesive may cause my eyes to tear up if I do not keep my eyes closed.
I disclosed any allergies that I may have.
not following these instructions are at my own risk. I confirm and agree that I wish to engage eyelash extension services at your business in my own will.