The technician explained to me well what the eyelash enhancement and eyelash tinting technique consists of, the care to take at home to keep them healthy and the potential risks if neglected. The information contained on this form is accurate. I have not made any false representations and have not withheld any medical information, surgical status or condition.

I understand that eye irritation, pain, itching and discomfort and, in rare cases, eye infection may occur in connection with the procedure.

I understand and agree to contact my technician if I experience any of these issues with my eyelashes and to seek medical attention at my own expense if necessary.

I understand that an allergic reaction cannot be controlled by the technician and I therefore release her from any responsibility.

I understand and agree to follow the aftercare instructions communicated by the technician.

I understand that I will need to keep my eyes closed during the procedure, which will last 60 to 120 minutes. I also understand that I will need to remain lying down for this period of time.

I consent to my eyelashes being curled with advanced solutions and dyed with black eyelash tint.

I agree that in very rare cases, with the natural eyelash growth cycle, the eyelashes could curve in multiple directions.

I agree to avoid water, steam and mascara + avoid sleeping on the lashes for 48 hours after the treatment. I understand that not following these instructions will cause an undesirable result.

I agree not to use any products containing oil (mascara, makeup remover or cream) on an eyelash lift.

I agree that there is no guarantee on the result or the hold of the eyelash lift.

This agreement will remain in effect for this procedure and all future procedures conducted by my technician Sarah Stamm.

I have read and understood all of the above information.

I allow the technician to take pictures of my eyes before and after the procedure.

COVID-19

I hereby certify that I do not have or have had any symptoms associated with COVID-19 in the past 14 days. This includes: fever, cough, shortness of breath, muscle aches, loss of smell or taste, diarrhea, nausea, or sore throat.

You acknowledge that the extreme health measures put in place cannot guarantee complete protection against COVID-19.

I acknowledge that by making an appointment, I accept all responsibility for the possibility of contracting COVID-19.

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By signing below, I acknowledge that I have read and understood all of the above and that I fully consent to it.

Technician's signature: _________________________________