Eyelash Extension Consent & Appointment Form
Client
First Name
Last Name
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Email
example@example.com
By checking the following boxes, confirm that you willingly consent to the following terms and conditions:
I hereby agree to have eyelash extensions applied to my natural lashes and consent to the placement and/or removal of the eyelash extensions by the certified professional.
I understand and agree to the after-care instructions and for any unexpected circumstance that have happened due to not following these instructions are in my own risk.
I understand that in rare occasions there are risks associated with having artificial eyelashes. I further understand that in rare circumstances eye or skin irritation and discomfort may occur.
I understand that because of the natural lash cycle and wear and tear, I will need to maintain my extensions with touch up appointments usually recommended about every 2 to 3 weeks to keep them full.
By checking the following boxes, confirm that you willingly consent to having the treatment during the COVID-19 pandemic:
I am aware of the risks of having hair services during the pandemic.
I understand that physical distancing of 6 feet may not be possible while in the salon receiving services.
I will follow the rules in order to minimize the spread of viruses. I understand that I must sanitize my hands before entering the salon and I must wear a mask that covers my mouth and nose while in common areas.
I confirm that I have not travelled domestically or internationally via public transportation within 14 days.
I do not have any of the following COVID-19 symptoms: cough, shortness of breath, high fever, muscle pain, body ache, nausea, loss of taste, loss of smell.
I have not contacted with anyone that have or may have COVID-19 symptoms or get infected within past 14 days.
I understand I may NOT bring children or anyone else who does not have an appointment into the salon.
I will immediately notify the salon if I contract the virus within two weeks following my visit.
Appointment
I verify that the information I have provided on this form is truthful and accurate.
Date
-
Month
-
Day
Year
Date
Client Signature
Submit
Should be Empty: