Beauty by Erin

Eyelash extension consent form

I agree to have eyelash extensions applied to my natural eyelashes and/or removed and retouched. By signing this agreement, I consent to the placement and removal of the eyelash extensions by the certified eyelash extension professional.

I understand there are risks associated with having artificial eyelashes and eyelash extensions applied to my natural eyelashes. I further understand that is a part of the procedure, eye irritation, eye pain, eye itching, discomfort, and in rare cases eye infection or blindness could occur. I agree that if I experience any of these medical conditions with my lashes that I will contact the certified eyelash extension professional and have the eyelashes removed immediately and consult a physician at my own expense. I understand that even though the extension professional applies or removes the eyelash extensions using the proper technique, the Instruments, tapes, cleaners, Eye gel pads, adhesives, and cleaners used may irritate my eyes or require a physicians follow-up care and subsequent removal of the eyelash extensions.

I understand and agree to the care instructions provided by the certified professional for use and care of my eyelash extensions. I realize and accept the consequences of failure to adhere to these instructions may cause eyelash extensions to fall out, become damaged, and/or decrease the time the lashes will last.

I understand and consent to having my eye closed and covered for the duration of the 90-150 minute procedure. I understand that I will have instruments, tapes, cleaners, eye gel pads, adhesives, and removers used that may irritate my eyes, causing them to water and blink excessively preventing application and/or requiring removal and a physicians follow-up care and subsequent removal of the eyelash extensions.

I am informing the professional of the following conditions by marking with a check

-Current use of contact lenses which I agree to remove during each lash application

-Current use of anything such as oil-containing sunscreen or moisturizers around the eyes

-Current use of eyedrops of any kind, prescription or over-the-counter

-Current allergies or sensitivities to instruments, fumes, tapes, cleaners, eye gel pads, adhesives, and removers that could cause my eyes to water and blink

-Claustrophobia

-History of recurrent eye or tear duct infections

-History of dry eyes

-Recent history of chemotherapy

I agree to the following eyelash extensions post-op and maintenance instruction:

No waterproof mascara

No oil based products around my eyes

No tinting or perming of eyelash extensions

No prescription or over-the-counter eyedrops

No water can come in contact with the eye area for 24 hours of the application

No continuous pulling or rubbing of the synthetic lashes

This agreement we remain in effect for this procedure and all other future procedures conducted by the professional. I 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 treatment.

I release my technician, Beauty by Erin from all liability associated with his procedure, which is performed with utmost attention to safety and proper education. This includes tools and products that the technician has been professionally trained to use. There are no guarantees for the bonding time length of eyelash extensions. Beauty by Erin, is not responsible for any technician errors. I understand the after care instructions and will do my part to maintain my eyelash extensions. I understand that there are many factors that could adhere the extensions. Such as water, moisture contact, weather conditions, and activities involving heat exposure to high temperatures. By signing below I verify that I have read and understand the above statement and agree to it.

By signing this consent form I agree and consent to letting my technician take before and after photos/videos which may be used for marketing purposes.