Lash Fox | Lash Fox Beauty Consent Form

Name *

First

Last

Email *

*Email may be used to confirm appointments, send notifications or promotions

Phone *

Birthday//

*Optional* For promo use only

How did you hear about us?

Emergency Contact *

First

Last

Emergency Contact Phone *

You must be over 18 to consent to services. You must be over 16 to receive services. Under 18 requires parental signature *

I am over 18
I am over 16

Parent Signature Required if client is under 18 (but must be over 16)

Have you ever used hair color before? *

Yes
No

If yes, have you ever had an allergic reaction to hair color? *

Yes
No

Do you wear contact lenses? *

Yes
No

It is highly recommended to remove contact lenses prior to your service. If product gets into your eye contacts will restrict the ability to flush the eye. This is optional, but highly recommended.

I understand

Have you ever had your brows or lashes tinted? *

Yes, Brows Only
Yes, Lashes Only
Yes, Both
No, Neither

If you had an adverse reaction to a previous tinting, please explain:

PLEASE READ AND UNDERSTAND THE FOLLOWING:

Each box check provides electronic confirmation & consent

Although every precaution will be made to ensure your safety and well-being before, during and after your tinting application, please be aware of the possible risks below. By signing the bottom of this page I acknowledge and accept the following:

I agree and consent to have a tint applied to my natural eyelashes and/or eyebrows. *

I agree
I would like to discuss this further

There are risks associated with having a lash tint. As part of the procedure, eye irritation, eye pain, eye itching, discomfort, and in rare cases allergic reaction, eye infection, or blurriness could occur. At my request I may have a patch test done at least 24 hours before my appointment. I agree that if at any time, I am uncomfortable with the tint treatment, I will inform the technician and she will gladly rectify the problem, including ending the session. *

I understand
I would like to discuss this further

Tinting lashes or brows has some inherent risk of irritation to the orbital eye area, including the eye itself, and could result in stinging or burning, blurry vision and potentially blindness should the tint enter into the eye. *

I understand
I would like to discuss this further

If any products come into contact with my eye, my eye will be flushed and I will be assisted in seeking medical attention immediately. *

I understand
I would like to discuss this further

For Lash Tinting - I understand and consent to having my eyes closed for the duration of an approximately 30 minute procedure and that it is my responsibility to keep them closed and remain still during this time. Procedure times vary.

I understand
I would like to discuss this further

There may be some residual dark staining left on the skin following the tinting process of either my lashes, brows or both. This will fade and go away within a short time. *

I understand
I would like to discuss this further

While every attempt will be made to provide me with my chosen color, everyone’s hair absorbs color differently and the result may not be the color I initially wanted. *

I understand
I would like to discuss this further

It is my responsibility to prepare my eye area prior to arrival. Eyelashes and Brows should be clean, dry, and free of mascara, makeup, and oil residue. If I attend my appointment without proper preparation, Lash Fox Beauty cannot guarantee lasting or satisfactory results and may charge me a cleaning fee prior to application. *For best results please let us know if you have any mascara or residue on your lashes. *

I understand
I would like to discuss this further

There are no guarantees for the length of time your tint will last. I understand the aftercare instructions and will do my part to maintain the tint. *

I understand
I would like to discuss this further

I understand and agree to the following after-care instructions for best results and longevity of the tint. I realize and accept the consequences of failing to adhere to these instructions may cause the tint to fade faster *

No water, sweat, steam, saunas or make-up for the first 24 hours
Avoid rubbing excessively and using sugar scrubs.
Waterproof mascara may be used, but the removal may decrease the tint. Regular mascara is recommended

Please check all to confirm the understanding of after-care.

We suggest checking with your doctor prior to having tint applied if you: have chronic dry eye, conjunctivitis, eye infections, trichotillomania, have recently undergone chemotherapy, or have recently had Lasik or blepharoplasty surgery. *

I understand
I would like to discuss this further

I understand the cancellation policy as follows: *

Cancellations must be made prior to 24 hours before scheduled appointment. If cancelled within 24 hours of appointment a cancellation fee will be due immediately.
If I fail to arrive to my appointment and give no notice I will be billed for 100% of the services cost
If I am more than 15 minutes late to my appointment I understand that it will be automatically cancelled and I will be charged accordingly.

Please check each box to confirm you agree to these terms

I understand services are non-refundable. *

I understand

OPTIONAL: I give Lash Fox Beauty permission to take, publish and reproduce photographs of me, my face, and/or my eye area, both before and/or after the procedure for advertising, training and other purposes.

Yes
No

If you would like to be tagged on Social Media please enter your user name(s)

If you have any questions please feel free to leave them here to discuss upon arrival. If you would like to discuss prior to your appointment please note that as well and we will be in touch,

This agreement will remain in effect for all lash lift and/or tinting procedures performed at Lash Fox Beauty. I will inform Lash Fox Beauty of any changes applicable to this agreement. I read English and understand that this agreement is legal and binding. I will not hold Lash Fox Beauty or any of its service providers liable for any damages on this day or any day forward. I have read and understand all information in this agreement. I am over 18 years of age and consent to this agreement and to the services rendered.

Client Signature *

Todays Date *

Lash Fox Beauty Consent Form – Lash and/or Brow Tint

PLEASE READ AND UNDERSTAND THE FOLLOWING: