EYELASH EXTENSION CONSENT

BOSTON LASH EYELASH EXTENSION CONSENT FORM

EYELASH EXTENSION

CONSENT FORM

PLEASE FILL OUT THE FOLLOWING FORM PRIOR TO YOUR FIRST APPOINTMENT.


NAME *
NAME
MOBILE PHONE NUMBER *
MOBILE PHONE NUMBER
OUR LASH ARTISTS COMMUNICATE PRIMARILY THROUGH TEXT MESSAGES.
ADDRESS *
ADDRESS
BIRTHDAY *
BIRTHDAY
HAVE YOU WORN EYELASH EXTENSIONS IN THE PAST? *
HAVE YOU EVER HAD A REACTION TO LATEX OR OTHER SYNTHETICS? *
ALTHOUGH IT IS IMPOSSIBLE TO LIST EVERY POTENTIAL RISK AND COMPLICATION, THE FOLLOWING CONDITIONS ARE RECOGNIZED AS CONTRAINDICATIONS FOR EYELASH EXTENSIONS AND MUST BE DISCLOSED PRIOR TO TREATMENT: *
please check all that apply or none.
IF NONE, TYPE NONE.
DO YOU GIVE BOSTON LASH PERMISSION TO TAKE AND/OR USE YOUR PHOTO FOR PURPOSES OF DOCUMENTATION, POTENTIAL ADVERTISING AND/OR PROMOTIONAL PURPOSES. *
PLEASE CHECK THE BOX BELOW EACH STATEMENT TO CONFIRM ACKNOWLEDGMENT.
I AUTHORIZE BOSTON LASH TO REMOVE OR APPLY EYELASH EXTENSIONS. I HAVE READ, UNDERSTOOD, AND STATED ANY ISSUES THAT MAY PREVENT ME FROM COMPLYING WITH THE SERVICE(S) PROVIDED. BOSTON LASH WILL NOT BE LIABLE FOR ANY CLAIM, LOSS, OR DAMAGE INCURRED, MEDICAL OR OTHERWISE, DUE TO OR AS A RESULT OF THE SERVICES THAT I HAVE RECEIVED AT BOSTON LASH. BOSTON LASH RESERVES THE RIGHT TO REFUSE ME SERVICE SHOULD THEY FEEL THE SERVICE WILL NOT BENEFIT ME ACCORDING TO MY INFORMATION ENTERED ABOVE. I RATIFY AND CONSENT TO ALL SERVICES RENDERED AT BOSTON LASH UNDER THESE TERMS. *
I AM AWARE THAT WHILE EVERY ATTEMPT WILL BE MADE TO PROVIDE ME WITH THE LENGTH AND FULLNESS I HAVE REQUESTED, MY NATURAL LASH LENGTH AND STRENGTH MAY CAUSE RESULTS TO DIFFER. BOSTON LASH CANNOT GUARANTEE THE FINAL RESULT. *
I KNOWINGLY AND FREELY ASSUME THE POSSIBILITY OF AN ALLERGIC REACTION. IF I EXPERIENCE AN ALLERGIC REACTION TO ANY OF THE PRODUCTS USED DURING MY SERVICE, I WILL CONTACT BOSTON LASH IMMEDIATELY TO ASSESS THE SITUATION. A REFUND WILL NOT BE GIVEN FOR AN ALLERGIC REACTION. *
IF I CANCEL OR RESCHEDULE MY APPOINTMENT I WILL GIVE 24 HOURS NOTICE OR I WILL BE CHARGED A $50 FEE. *
I WILL NOT BRING MY CHILD/CHILDREN OR PETS TO MY APPOINTMENT. *
IF I HAVE RETAINED LESS THAN 30% OF MY LASHES BETWEEN FILLS, I MAY BE CHARGED FOR A FULL SET. *
IF I AM CURRENTLY WEARING EXTENSIONS FROM ANOTHER SALON, I UNDERSTAND THAT IT IS AT THE DISCRETION OF BOSTON LASH TO REMOVE EXTENSIONS THAT HAVE NOT BEEN APPLIED PROPERLY AND THAT I WILL BE CHARGED FOR A 3 WEEK FILL. *
I AGREE TO FOLLOW THE AFTERCARE INSTRUCTIONS PROVIDED BY BOSTON LASH FOR THE USE AND CARE OF MY EYELASH EXTENSIONS AND BOSTON LASH IS NOT RESPONSIBLE FOR ANY DAMAGE I MAY CAUSE TO MY EYELASH EXTENSIONS OR MY OWN EYELASHES/EYES. *
IF I WEAR CONTACT LENSES, IT IS AT MY OWN DISCRETION TO REMOVE THEM DURING MY SERVICE. *
IF I AM BREASTFEEDING, PREGNANT OR ARE TO BECOME PREGNANT, I WILL ADVISE MY PHYSICIAN BEFORE RECEIVING ANY SERVICE AT BOSTON LASH. *
I REPRESENT THAT I AM OVER THE AGE OF 18. IF I AM UNDER THE AGE OF 18, I WILL ARRIVE WITH A PARENT OR GUARDIAN WHO WILL BE REQUIRED TO COMPLETE A RELEASE FORM BEFORE ANY SERVICE IS PROVIDED. *
BOSTON LASH CARRIES A NO REFUND POLICY FOR SERVICES OR PRODUCTS. *
BY CLICKING SUBMIT ON THE BUTTON BELOW, YOU FULLY AGREE TO HAVE READ, UNDERSTAND, AND ACCEPT ALL FORMS OF CONSENT. IF ANY OF THE INFORMATION SUBMITTED SHOULD CHANGE BETWEEN APPOINTMENTS, IT IS YOUR RESPONSIBILITY TO INFORM BOSTON LASH IMMEDIATELY.