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Client Information/ Consent (Henna, Lash & Brow Tinting, Lash Lift & Lash Extensions)

LASH EXTENSIONS

Before your appointment:

-Avoid using waterproof mascara 2-3 days before your first appointment

-Make sure you have clean lashes and make-up free eyes

-No use of tanning beds within 48 hours of appointment

Initial appointment (24-48 hr. aftercare)

-Avoid getting lashes wet for 24 hours after your appointment

-Avoid steam, showers, facials, saunas & swimming pools -Avoid tanning beds for 48 hours

-Avoid chemical peels, waxing, laser treatments around the eyes

Extend lashes:

-Avoid using oil-based skincare and makeup products

-Avoid running water over your face (moisture breaks the bond of the glue)

-Avoid rubbing eyes or lashes (use Q-tip, wash cloth or cotton swab to clean eyes)

-It’s recommended to sleep on your back (avoid risk of rubbing lashes against your pillow)

-Gently brush lashes with a clean mascara wand to groom them (best time to do is after showering)

-Avoid pulling your lashes and do not remove them yourself

Please initial below:

- I understand that if the bonding agent encounters my eye, my eye will be flushed with water, and I will be assisted in seeking medical attention immediately.

- I understand that lash extensions services have some inherent risk of irritation to the orbital eye area, including the eye itself, and could result in stinging and burning, blurry vision and potential blindness should the adhesive enter the eye or should and allergic reaction occur.

- I understand that it is imperative that I disclose the information requested in the Client Profile/ Health History.

- I understand the additional conditions could occur or be discovered during the procedure which could affect my ability to tolerate the procedure.

Please answer the questions below (ALL SERVICES):

Do you wear contacts/ glasses?
Have you ever had lash extensions?
Have you used Latisse or any other lash growing products?
Do you have any allergies (cosmetics/ingredients)?
Do you have any eye diseases, conditions or injuries that has affected your hair/ lash growth or loss?
Are you allergic to Acrylate/ Cyanoacrylate (bonding agent) or any other bonding agents or glues?

Henna/ Lash & Brow Tinting

Have you used hair color before?
Any allergic reactions to hair color?

Circle One

What side do you sleep on most?
How fast do you feel your hair grows?

EYELASH LIFT

Please initial below:

- I understand that there are risks associated with having an eyelash lift - understand that as part of the eyelash lift procedure, eye irritation, pain, itching, discomfort, infection, and blurriness

- I agree that if I experience any of these conditions with my eyes or eyelashes, I will contact my esthetician; If I choose to contact my physician it will be at my own expense

- I understand that an eyelash lift will lift my natural eyelashes so results will vary

- I understand and consent to having my eyes closed and covered for the entire duration of the procedure

LASH & BROW TINTING

Please initial below:

- I understand that tinting lashes/brows have some inherent risk of irritation to the orbital eye area

- I understand that some irritation or burning may occur when the tinting agent encounters the skin

- I understand that there maybe some residual dark staining left on the skin following the tinting process (lashes or brows), it will fade away within a short time

- I understand over the course of several weeks the tint will gradually lighten or fade (re-tint every 3-4 weeks)

- I understand that while every attempt will be made to provide me with the chosen color, everyone’s hair absorbs differently, and my results may not be the color I initially wanted

HENNA BROW ART

Before Treatment:

-You must be off Accutane or any prescribed acne medications for 10 days (NO EXCEPTIONS) -Do not tan or sunbathe 30 days before/ after procedure

-Do not have any chemical peels, microdermabrasion, mesotherapy or any intense treatments, it will cause faster skin cell rejuvenating & cause skin irritation 3-4 weeks before the procedure

After Care:

-Avoid sun, saunas, and pools for 24 hours after treatment

-Moisturize the area with your regular moisturizer to keep skin hydrated and avoid flaking

-Don’t rub the area

Please initial below:

- I understand that tinting lashes/brows have some inherent risk of irritation to the orbital eye area

- I understand that some irritation or burning may occur when the tinting agent encounters the skin

- I understand that there maybe some residual dark staining left on the skin following the tinting process (lashes or brows), it will fade away within a short time

- I understand over the course of several weeks the tint will gradually lighten or fade (re-tint every 3-4 weeks)

- I understand that while every attempt will be made to provide me with the chosen color, everyone’s hair absorbs differently, and my results may not be the color I initially wanted

Thanks for submitting!

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