THIRTY FOUR NAILS

Lash Extension consent form

Lash Consent Form

First name

Phone

Do yo have any allergies?

YES

If Yes please specify

Have you had eyelashes applied before?

YES

Last name

Address

Are you on any medications?

YES

If Yes please specify

If you have never had eyelashes applied before, we recommend a patch test. However you may opt out should you wish. Please indicate this below

I confirm that I would like to opt out of the advised adhesive patch test

Please tick the statement below to show your understanding

I confirm that I understand that a patch test does not guarantee that a adverse reaction will not occur

Do you perm or curl your lashes?

YES

Have you ever experience any extensive loss or damage to your lashes when you perm or curl your lashes

YES

Do you wear contacts?

YES

Have you ever had or are being treated for any eye illness or injuries?

YES

Are you able to keep your eyes closed and sit still for up to 2 hours?

YES

Please tick each statement to show your understanding and agreement.

I understand that in rare occasions there are risks associated with having artificial eyelashes and eyelash extensions applied to or removed from my natural eyelashes.

I further understand that in rare cases as part of the procedure eye irritation and discomfort could occur.

I agree that if I experience any of these conditions with my eyelashes that I will contact the certified eyelash extension professional that performed this procedure and it may be beneficial to have the eyelashes removed.

If I am concerned about any of these conditions I will seek medical advice immediately.

Pre Treatment Guidance

Please, remove all eye makeup by using a gentle, non-oil-containing cleanser. Eye makeup affects the adhesive bond and reduces how long your eyelash can last.
If you’re wearing contact lenses, remove them.
The whole procedure often takes between 90 to 150 minutes for a complete set. Fills take between 30 to 90 minutes. Therefore, please wear clothing that you’ll be comfortable in for the duration of the procedure.
To ensure you are comfortable go to the bathroom before the procedure.
Do not apply face creams or sunblock on the portion of the eyes that is to be treated. Many moisturizers contain oils that prevent adhesives from sticking to the natural eyelash and shorten the lifespan of the eyelash extensions.
Do not wear mascara. Cleaning mascara takes a lot of time and the makeup that is left can obstruct the effectiveness of the extension applied.
Do not curl your eyelashes before the appointment. Extensions don’t fit well with wavy eyelashes.
Put your phone on silent mode during the extension application. Communication in the treatment location is not advised because precision is required in the process. You are free to rest or listen to audio during the extension application.
If you currently have eyelash extensions that were not put on by us, please schedule a removal service on your first visit. It is best to prevent the harm that comes with mixing various adhesives and materials with extensions from other salons.

Maintence and aftercare

Avoid getting your eyelashes wet for 48 hours after application - The water will react with the eyelash extension glue and cause a flash cure. The water will cause the eyelash bond to become brittle and break. After the 48-hour period, you’re safe to shower again. Top tip: When showering, don’t position your head in the full strength of water flow. Let the water instead run down your face.
Do not rub or touch your eyes.
Clean with eyelash foam cleanser every 3 days - Using a soft bristle brush and specialist eyelash extension cleaning foam, clean approximately every 3 days. Getting into this habit removes traces of natural oils, dust and makeup. This prevents any build-ups causing pressure on your lashes and breaking down the bond. Ultimately, you need to clean clean clean to avoid premature eyelash shedding.
Brush through your eyelash tips in the morning.
Do not apply mascara - The product gets caught between the eyelashes and builds up. This, in turn, becomes much harder to clean and may lead to premature eyelash loss and affects your eye health.
Do not use oil-based products around or on the eyes.
Do not sleep on your face.
Stay on top of your infills (recommended every 2 - 3 weeks).

Please tick this box to confirm

I have read and understood the aftercare advice provided to me on this form.

Consent

I accept that any treatment I will receive is at my own risk.

I certify that I have read, fully understood, and completed this form to the best of my knowledge.

I understand that failure to disclose the information requested above may result in adverse side effect(s), unknown because of this to which I accept full liability/responsibility.

The treatment(s) and possible side effects (s) have been fully explained to me.

I accept full responsibility for the treatment given and complications that may arise or result during or following any procedure performed at my request.

I accept that if I am not satisfied with the treatment I will inform the therapist and request to speak to the manager during, or immediately following the treatment.

I fully understand the above and consent to the Eyelash Extensions treatment(s) to be carried out.

Choice 1

Your Signature

Thanks for submiting!