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Lash Lift Consent Form
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First and last name: *
Date of procedure: *
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Date of birth: *
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Is this your first time receiving a lash lift? *
If you answered no, when was the last time you received a lash lift?
Have you used a lash growth serum in that last 6 months? *
If yes, please list serum:
I understand that there are risks associated with the lash lift procedure. *
I understand that my natural lashes will be curled with an advanced solution. *
I understand that as part of the procedure eye irritation, pain, itching, discomfort and, in rare cases, eye infection may occur. *
I understand and agree to follow the aftercare instructions provided by my technician. *
I understand failure to follow the aftercare instructions may cause an undesirable result. *
I understand that in order to have a lash lift procedure I will need to keep my eyes closed for a duration of up to 75 minutes during the procedure. I also understand that I will need to be lying down. Any medical conditions that might be aggravated by lying still for a prolonged period of time may mean that I will not be able to have the procedure performed on my eyes. *
I understand that opening my eyes at any point during the lash lift procedure is not recommended and may cause an undesirable result. I agree to keep my eyes closed throughout the procedure unless instructed to open them by my technician. *
This agreement will remain in effect for this procedure and all future lash lift procedures conducted by my technician or any other technician conducting business at Vine Lash & Beauty Co. I understand that this agreement is binding and that I have read and fully understand all information above. I represent that I am over the age of 18 years old. If below 18 years of age a parent or guardian must also sign this form. *
I release my technician and Vine Lash & Beauty Co. from all liabilities associated with this procedure. There are no refunds, and there are no guarantees for how long the lash lift will last. On average it lasts between 8-10 weeks. Our company or salon is not responsible for any technician errors. *
I understand that I have been advised to follow the aftercare protocol from my technician so as to avoid any discomfort or adverse effects after the procedure has been completed. *
Please type your full name, (if under 18 years of age please also type the parent or guardian's name), below to confirm that you understand and accept these liabilities and policies. *
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