LASH WAIVER AND RELEASE FORM | London Amari Studio

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eyeLash Waiver & Release Form

I understand that this procedure requires single mink blend eyelashes to be glued to my own natural eyelashes.

Yes

I understand that it is my responsibility to keep my eyes closed and be still during the entire procedure, until my eyelash technician addresses me to open my eyes.

Yes

I understand that some risks of this procedure may not be limited to eye redness and irritation. The fumes from the adhesive may cause my eyes to tear up if I open my eyes.

Yes

I agree to disclose any allergies that I may have to latex, surgical tapes, cyanoacrylate (found in household glues, Vaseline, etc.)

Yes

I understand that I am required to follow the eyelash extension after care instructions in order to maintain the life of these extensions.

Yes

I agree that by reading and signing this consent form, I release the lash artist from any claims or damages of any nature.

Yes

I agree that I read and fully understand this entire consent form.

Yes

I am of sound mind and fully capable of executing this waver for myself.

Yes

I give the lash artist permission to show my before and after photos of eyelashes to other potential clients.

Yes

No

I have read and completed the Client Registration form & Eyelash History form in its entirety/ and have answered everything to the best of my ability. I have been informed of potentially harmful or negative side effects that may be caused by the application and/or removal of Eyelash Extensions

Yes

I confirm and agree that I wish to engage the services of the lash artist to apply eyelash extensions.

Yes

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