Lash Lift Intake "*" indicates required fields Lash Lift IntakeClients Name* First Appointment Date* MM slash DD slash YYYY Have you had a Lash Lift in the past?*- Select One -YesNoList any allergies you haveHave you had your lashes tinted in the past?*- Select One -YesNoHave you ever had an allergic reaction to hair color?*- Select One -YesNoList any medications you are currently takingTerms & Conditions, please read & select each one:Consent* I understand to not pluck, pull, or cut my natural lashes*Consent* I understand I cannot get my lashes wet or apply eye makeup for at least 24 hours after every lash lift appointment, as it will affect my results*Consent* I understand to come without contacts in or to remove them prior to the service, so there is no irritation*Consent* I agree that if at any time I am uncomfortable with the lash lift or lash tint, I will inform the technician & she will gladly rectify the problem, including ending the session*Consent* I understand there are risks associated with having a lash lift and tint. I further understand that as part of the procedure, eye irritation, eye pain, eye itching, discomfort, & in rare cases allergic reactions could occur.*Consent* I am aware that a lash lift lifts my natural lashes. Depending on my natural lash length and strength, results may vary.*Consent* I understand and consent to having my eyes closed for the duration of the treatment*Consent* I am aware that using a lash growth serum may affect my results*We strongly suggest not receiving a lash lift or tint if you are pregnant, nursing, have chronic dry eye, conjunctivitis, damaged lashes, eye infections, have recently undergone chemotherapy or have extremely short lashes. You need to wait a year after having LASIK or blepharoplasty surgery. By signing below I authorize a Licensed esthetician to perform a lash lift & tint on my eyelashes. The treatments I receive here are voluntary & I release this institution and/or professional from liability and assume full responsibility thereof. If any information changes between my appointments, i will let my specialist know.
