eYELASH eXTENSIONS Consent

 

DESCRIPTION OF TREATMENT

Eyelash extensions are applied to your natural eyelashes using a chemical adhesive. The treatment requires maintaining your eyes closed and covered for the duration of the approximately 60- to 180-minute procedure. Procedure times vary depending on the type and number of eyelashes applied.

POTENTIAL RISKS AND SIDE EFFECTS

In rare cases, irritation can occur as part of the procedure including:

  • Burning sensation to the eyes

  • Watery eyes

  • Coughing

  • Nausea

  • Skin irritation

If you experience any of these conditions in association with your lash extension treatment, you should contact the professional that performed the procedure as it may be beneficial to have the extensions removed.

Notification of relevant conditions

If you have any of the following conditions, you must inform your eyelash technician as they may affect you ability to undergo the procedure:

  • Current use of contact lenses (you may be asked to remove during the procedure)

  • Current use of anything such as oil-containing sunscreen or moisturizers around the eyes

  • Current use of eye drops of any kind, prescription or over-the-counter

  • Current allergies or sensitivities

  • History of recurrent eye or tear duct infections

  • History of dry eyes or Sjorgen’s Syndrome

  • Recent history of chemotherapy

  • Other medical conditions which would prohibit or compromise placement and retention of eyelash extensions

aFtercare

To ensure your lash extensions last as long as possible, it is important to adhere to the following aftercare instructions. Failure to follow these instructions may cause the eyelash extensions to detach from your natural lashes or lead to your natural lashes falling out prematurely:

  • No waterproof mascara

  • No oil based products in the eye area

  • Avoid water exposure the eye area for 24 hours after eyelash extension application

  • No tinting or perming of eyelash extensions

  • No pulling or rubbing of the eyelash extensions

  • Should any kind of eye drops be necessary, take care to prevent moisture from coming into contact with lash extensions

PATIENT CONSENT

This agreement will remain in effect for this procedure and all future follow-ups conducted by the certified eyelash extension professional. I have read and understand that this consent agreement is legal and binding. I have read and fully understand all information in this agreement. I am over 18 years of age and consent to the agreement and to the eyelash extension application procedure.