Your letterhead/Logo here
XXX means you or your company
EYELASH EXTENSION AGREEMENT AND LIABILITY WAIVER
Client Name.……………………………………… Date………………………………………..
Telephone………………………………………….. Email………………………………………
Home Address……………………………………….Postal Address……………………………
I hereby agree to have my natural eyelashes extended and/or retouched by xxx.
I understand that even though xxx will exercise utmost care and skill in performing the said procedure, there still exist risks associated with the procedure and products employed in the procedure. These include, without limitation, eye irritation, pain, itching, and discomfort and in rare cases eye infection. In the event I experience any of these issues with my eyelashes, I will contact xxx and have the eyelash extensions removed immediately and thereafter consult a physician at my own expense.
I understand and agree to the after-care instructions provided by xxxx for the use and care of my eyelash extensions. I realize and accept the consequences of failure to adhere to these instructions may cause the eyelash extensions to fall out and/or decrease the time the lashes will last.
By this agreement, I further confirm that I have disclosed any and all allergies that I may have to latex, surgical tapes, cyanoacrylate, Vaseline, and any other equipment or chemicals applied in the procedure.
This agreement will remain in effect for this procedure and all future procedures conducted by xxxx.
I confirm that I have read and fully understood this entire agreement and do agree to waive any liability that may arise against xxx from the procedure.
Client signature__________________ Technician Signature________________
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