New Client Form

I agree to the following:

By signing this agreement, I give consent to the esthetic professional to preform any of the following services: Eyelash extensions, lash lift, brow lamination, microdermabrasion tinting, or waxing.

I understand that in rare occasions there are risks associated with any of the above services. I further understand that in rare cases as part of the procedure, irritation and discomfort could occur. I agree that the technician/ company is not held responsible and I freely assume all risks.

I understand and agree to the after-care instructions provided by the esthetic professional. I realize and I accept any consequences such as: irritations, lash shedding, unsatisfactory outcomes etc., if I do not follow the after care instructions.

I am informing the esthetic professional of the following conditions by marking with a check- NOTE: any selection will compromise the service: (Please only select the conditions that apply to you)

Current use of contact lenses which I may be asked to remove during the procedure

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

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

Current allergies or sensitivities

History of recurrent eye or tear duct infections

History of dry eyes or Sjorgen’s Syndrome

Recent history of Chemotherapy

Other medical conditions which would prohibit or compromise placement and retention of eyelash extensions

New Client Form

Please fill out the following form in order to proceed with your appointment.