Release of Liability Waiver - Eyleash Extensions

Release of Liability Waiver: Eyelash Extensions

Name

First

Last

Client History

1. Have you ever received eyelash extension before?

Yes, date of last service: Yes, date of last service:

No

2. Do you currently have any eye infections or eyesight difficulties?

Yes, please specify:Yes, please specify:

No

3. Do you have any known eye allergies to substances or cosmetics?

Yes, please specify: Yes, please specify:

No

Client Consent

1. I agree to use only recommended products on my eyelash extensions.

2. I understand that there are many variables including technician expertise, natural lash growth cycle, use of cosmetics and skin care products, and the overall maintenance given that will influence how long my eyelash extensions remain in place.

3. I acknowledge that I should not pull on my lashes after they have been applied.

4. I understand that if a lash extensionist does not apply eyelash extensions properly there is a risk of eye damage and harm to my vision.

5. I understand that there is a possibility of allergic reaction – as with all cosmetic products. 
If there is a reaction within the first 48 hours after the service, we are happy to remove the eyelash extensions free of charge. Due to the time and material required for eyelash extensions full refunds will not be granted.

6. I have been advised that using mascara on a regular basis will shorten the length of time my extensions remain in place. I have also been advised not to use waterproof mascara on my eyelash extensions.

7. I understand that touch-up appointments may be necessary as soon as two to three weeks after the applications and that there are additional fees for this procedure.

8. I understand that any issue or dissatisfaction with the service must be discussed with the eyelash extensionist prior to leaving Spa Escape. We are happy to provide corrections or adjustments to ensure you are pleased with the result. Due to the time and material required for eyelash extensions full refunds will not be granted.

9. Spa Escape will not touch up or fill eyelash extensions received from other businesses. We can remove existing lashes free of charge and apply a full set of our own to ensure quality, cleanliness, and long lasting eyelash 
 extensions.

Signature

Clear

I confirm to the best of my knowledge, that the answers I have given are correct and that I have not withheld any information that maybe relevant to my treatment. I have read and discussed the above information with my Spa Escape Extensionist. I agree to hold Spa Escape, and its employees harmless for any and all side effects, which may result from my informed decision to receive eyelash extensions. I authorize Yolanda Rosenthal to apply Eyelash Extensions to my eyelashes.