I understand that lash extension services have some inherent risk of irritation to the orbital eye area, including the eye liselt, and could result in stinging and burning, blurry vision and potential blindness should the adhesive eater the eye or should an allergic reaction occur. I understand that some initation, itching or burning may occur on the skin if the bonding agent encounters it! understand that if the banding agent encounters my eye, my eye will be flushed with water, and I will be assisted in seeking medical attention Immediately.

I understand that this is a semi-permanent procedure, as my natural lashes will continue to grow and fall out normally, making Touch-up or "fill" appointments necessary to maintain the original look achieved by replacing the lashes that have fallen out. understand that while every attempt will be made to provide me with the length and fullness I have chosen, my result may not be what I initially envisioned.

I have cited all conditions and circumstances regarding my health history, medications being taken, and any past reactions to products or medications. I understand that additional condition ld occur or be discovered during the procedure which could affect my ability to tolerate the precedure.

I consent to "before and after" photographs for the purpose of documentation, potential advertising, and promotional.

I agree that if I experience any of ill effects with my lashes that will contact the certified eyelash extension professional that performed this procedure. I understand that if I experience effects, it may be beneficial to have the eyelashes removed.

I am informing the certified eyelash extension professional of the following conditions that apply to me (check all that apply):

I currently use contact lenses (which I may be asked to remove during the procedure)I currently use pruducts such as oil-containing sunscreen or moisturizers around my eyesI currently use eye drops I have allergies or sensitivitiesI have a history of recent eye or tear duct infectionsI have a history of dry eyes or Sjogren's SyndromeI have a recent history of ChemotherapyI have other medical conditions which would prohibit or compromise placement ant retention of eyelash extensions.

No waterproof mascarsNo oil-based products around the eye areaNo water can encounter the eye area for 24 hours after the applicationNo tinting or perming of eyelash extensionsNo pulling or rubbing of the eyelash extensionsShould any kind of eye drops be necessary extra care should be talian to prevent moisture free encountering the lash extensions.