Lash Lift Consent

Please fill out this form prior to your appointment.

Appointment Date

First name

Last name

Have you ever had a lash lift before?

If you had a lash lift before, did you have any problems with it?

By checking this box permission is granted to take photos of my eyes/face which may be used for marketing purposes on a website, salon or social media. (Those with Model Appointments MUST select this or full price will be charted)

Consent/After Care Instructions

I agree to have an eyelash lift applied to my natural eyelashes. By signing this agreement, I consent to the procedure of an eyelash lift by my esthetician. I understand there are risks associated with having an eyelash lift. I further understand that as part of the procedure, eye irritation, eye pain, eye itching, discomfort and in rare cases eye infection or blurriness could occur. I agree that if I experience any of these medical conditions with my lashes that will contact my esthetician and consult a physician at my own expense. I understand that even though my esthetician performs Lash Lifts using the proper techniques, the instruments, cleansers, adhesives, eye gel pads, and removers used may irritate my eyes or require a physicians follow-up care. I understand and agree to the care instructions provided by my esthetician for the care of my Lifted lashes. I realize and accept the consequences of failure to adhere to these instructions may cause to the eyelashes to not stay lifted as long as told. I understand and consent to having my eyes closed and covered for the duration of the 45-60 minute procedure.

I agree to following eyelash aftercare and maintenance instructions. No water can come in contact with the eye area for 24 hours after my appointment.

I read English and understand 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 treatment. I release Skin Envee and my esthetician from all liability associated with this procedure which is performed with the utmost attention to safety and proper application using tools and products that the esthetician has been professionally trained to use. There is no guarantees for length of time the lashes will stay lifted. I understand the aftercare instructions and will do my part to maintain my eyelashes. I understand that there are many factors that may affect the life of the eyelash lift such as water and moisture contact, weather conditions and activities involving exposure to high temperatures.

By signing below I verify that I have read and understand the above statements and agree to them.

Signature

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