Extension Client Waiver Form

Name

First NameLast Name

Email

example@example.com

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Billing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Have you had lash extensions before?

Do you wear contact lenses?

Do you wear glasses?

Have you had any surgery around the eye area in the last 6 months?

Do you have a latex allergy?

Is there a condition you have that you want to tell?

I understand that receiving extensions involves certain risks, including but not limited to possible irritation, allergic reactions, or damage to my natural hair or lashes. I have disclosed all relevant health conditions, allergies, and sensitivities to my technician, and I acknowledge that results may vary from person to person with no specific outcome guaranteed. I accept full responsibility for following the aftercare instructions provided to me and release my technician and the salon/business from any liability for reactions or issues that may occur as a result of this service. By signing below, I confirm that I have read, understood, and voluntarily agree to proceed with the extension service.

Signature