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lash lift correction consent form
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lash lift correction consent form
[Kanata] Lash lift correction consent
Client Consent Form for Lash Lift Correction (Over-Curled Lashes)
Client name
(Required)
First
Last
Phone
Email
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Date
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Service request
(Required)
Correction of over-curled or over-processed lash lift performed at another salon.
IMPORTANT INFORMATION – PLEASE READ CAREFULLY
You are requesting a corrective lash lift service to address an over-curled or improperly lifted result caused by a previous lash lift at another establishment. This procedure carries additional risks due to the pre-existing condition of your natural lashes. Please read and acknowledge the following:
1 Condition of Current Lashes:
(Required)
I understand that my lashes were previously lifted at another salon, and they may now be over-curled, frizzy, brittle, or uneven. Beauty Time Centre Inc. – Eyelash Studio is not responsible for damage caused by the original service.
I agree
2 Correction Limitations:
(Required)
I understand that lash lift corrections are delicate and results are not guaranteed. In some cases, only a partial improvement may be possible. My technician will do their best based on the condition of my natural lashes.
I agree
3 Risks Involved:
(Required)
I acknowledge that due to prior chemical exposure:
- My lashes may be more fragile or prone to breakage.
- A secondary chemical treatment may not be advisable or fully effective.
- There may be a risk of lash loss or further curl distortion.
- In some cases, we may recommend waiting for natural lash regrowth before further treatment.
- Eye irritation, redness, or stinging during or after the procedure.
- Allergic reaction to products used (e.g., solutions, adhesives, tape). Symptoms may include swelling, itching, or rash.
I agree
4 Aftercare Commitment:
(Required)
I agree to follow the aftercare instructions provided to support lash recovery and prevent further damage.
I agree
5 Important Disclosures
(Required)
- I understand that the success of the correction depends on the condition of my lashes and the previous application. While Beauty Time Eyelash Studio will do its best to achieve an optimal result, complete reversal or perfect results cannot be guaranteed.
- I acknowledge that there may be a need for multiple sessions to achieve the desired correction, especially if the over-curl is severe.
- I will inform my technician immediately if I experience any discomfort or unusual symptoms during the procedure.
- I have disclosed any known allergies, sensitivities, or medical conditions that may affect this service.
- I understand the importance of following the aftercare instructions provided by Beauty Time Eyelash Studio to maintain the health of my lashes and the longevity of the correction. Failure to do so may result in adverse effects or compromise the results.
- I understand that there will be a service charge for this correction
I agree
6 Medical Conditions / Allergies:
(Required)
I have no known allergies or medical conditions related to lash services.
Other
Client Acknowledgment and Consent
(Required)
By signing below, I confirm that:
• I have read and fully understand the information provided in this consent form.
• I have had the opportunity to ask questions, and all my questions have been answered to my satisfaction.
• I understand the nature of the over-curled lash correction service, including its potential benefits and risks.
• I voluntarily consent to receive the over-curled lash correction service at Beauty Time Eyelash Studio.
I agree
Client signature
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technician signature
(Required)
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Date
(Required)
MM slash DD slash YYYY
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Date
(Required)
MM slash DD slash YYYY