digital eyelashes waiver - WaiverElectronic

First and Last Name: * Please enter your name.

Please fill in Address: *

Please enter address.

Phone number: * Please enter your phone number.

Email: * Please enter your email.

Is this your first time having eyelash extensions applied? *

Yes

No

Please select at least one choice above.

If this is NOT your first time having eyelash extensions applied, where have you gotten them applied in the past? What product OR brand was used? What size AND/OR style of lashes were used? Please enter your answer here.

Do you wear contact lenses? *

Yes

No

Please select at least one choice above.

Do you habitually rub, pull or pick at your eyelashes? *

Yes

No

Please select at least one choice above.

Do you currently have or are you currently being treated for any eye illness, injury, or allergy? *

Yes

No

Please select at least one choice above.

If you replied yes, please list what you are being treated for and how you are treating it. Please enter your answer here.

Are you able to lie still and keep your eyes closed for up to two hours or more? *

Yes

No

Please select at least one choice above.

Which side do you predominantly sleep on? *

Left

Right

Please select at least one choice above.

How did you hear about LASHBOMB STUDIOS Midvale? *

Facebook

Google

Yelp

Friend/Other

Our Website

Please select at least one choice above.

If Friend/Other, please let us know so we can thank them! Please enter your answer here.

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I understand that this procedure requires single synthetic mink eyelashes to be glued to my own natural eyelashes. * Please click the yellow area and provide your initials here.

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I understand that it is my responsibility to keep my eyes closed and remain still during the entire procedure, until my eyelash technician instructs me to open my eyes. * Please click the yellow area and provide your initials here.

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I understand that some risks of this procedure may include, but are not limited to: eye redness & allergies. I also understand that the fumes from the adhesive may cause my eyes to tear up. * Please click the yellow area and provide your initials here.

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I agree to disclose any allergies that I may have, including those latex, surgical tapes, cyanoacrylate (acrylic), Vaseline, collagen, or adhesives of any kind. Please list any allergies below. * Please click the yellow area and provide your initials here.

Please list any allergies here: Please enter your answer here.

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I understand that I am required to follow the Eyelash Extension Care Sheet (provided by LASHBOMB STUDIOS Midvale) in order to maintain the life of my eyelash extensions. * Please click the yellow area and provide your initials here.

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I understand that lash fills need to be every 2-3 weeks. In addition, at 4 weeks, I understand that unless I have previous consent from my regular lash artist, I will be required to get a full set due to the extreme duration between fills. * Please click the yellow area and provide your initials here.

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I agree to communicate with my lash artist any discomfort, dissatisfaction, or general problems I may be having with my lashes or eye immediately & agree to follow the 72-hour Satisfaction Policy. * Please click the yellow area and provide your initials here.

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I understand that the lash technicians at LASHBOMB STUDIOS Midvale are Independent Contractors and prices are subject to change without notice. * Please click the yellow area and provide your initials here.

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I agree that by reading and signing this consent form, I release LASHBOMB STUDIOS Midvale from any claims or damages of any nature. * Please click the yellow area and provide your initials here.

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I am of sound mind and fully capable of executing this waiver for myself. * Please click the yellow area and provide your initials here.

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I agree that I have read and fully understand this entire consent form. * Please click the yellow area and provide your initials here.

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I am 16 years old or younger and have a parent of guardian present. Please click the yellow area and provide your initials here.

Your Signature *

Click to sign

Please sign here.

Parent/Legal Guardian Signature

Click to sign

Please sign here.

Please Enter Date *

Please enter valid date.

I give LASHBOMB STUDIOS Midvale permission to show my before and after photos of eyelashes to other potential clients, also to be posted on our website, or other social media sites. *

Yes

No

Please select at least one choice above.

Your Signature *

Click to sign

Please sign here.

Parent/Legal Guardian Signature

Click to sign

Please sign here.

Please Enter Date *

Please enter valid date.

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I understand that LASHBOMB STUDIOS Midvale has a 48-hour Satisfaction Policy and agree to notify LASHBOMB STUDIOS Midvale within 48-hours of my appointment if I am unsatisfied with my eyelash extensions in any way so that I can be scheduled to have my extensions fixed by my ORIGINAL LASH ARTIST, free of charge. I understand that any amount of time after 48 hours of my appointment will result in the possibility of paying for up to a full fill price. * Please click the yellow area and provide your initials here.

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I understand that I need to pay for my appointment upon arrival. * Please click the yellow area and provide your initials here.

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I understand that LASHBOMB STUDIOS Midvale has a 24-hour Cancellation and Reschedule Policy. I agree to give 24 hour notice if I cannot make my appointment for any reason. I understand that failure to provide LASHBOMB STUDIOS Midvale 24 hours' notice will result in a $25.00 fee. * Please click the yellow area and provide your initials here.

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I agree to show up to my appointments on time. I understand that arriving late to my appointment will affect the lash artists ability to provide me with the fullest of eyelash extensions I might possible be able to have and the lash artist is not at fault. Failure to show up or my appointments within 15 minutes of the scheduled time will result in the possibility of needing to reschedule my appointment I will need to pay the $25.00 No Show Fee. * Please click the yellow area and provide your initials here.

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I agree to come to all my lash appointments free of eye makeup. Should I come to my appointment with eye make up on and the lash artist has to remove it, I understand that I will need to pay a $10 makeup removal fee. I also understand that I will not be given additional time for my appointment to make up for lost time needed to remove the makeup. * Please click the yellow area and provide your initials here.

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I understand that as of January 1, 2016, LASHBOMB STUDIOS Midvale no longer accepts checks as a form of payment and I agree to provide cash or card to pay for my appointments. * Please click the yellow area and provide your initials here.

Your Signature

Click to sign

Please sign here.

Parent/Legal Guardian Signature *

Click to sign

Please sign here.

Please Enter Date *

Please enter valid date.

Waiverelectronic is the best electronic eyelash waiver all over the world.

LASHBOMB STUDIOS Midvale

Eyelash Extensions Agreement and Consent Form

Please read thoroughly and initial next to each statement:

LASHBOMB STUDIOS Midvale

Social Media Agreement and Consent Form

LASHBOMB STUDIOS Midvale

Policy Agreement

PLEASE GIVE THIS DEVICE BACK TO THE RECEPTIONIST

Waiverelectronic is the best electronic eyelash waiver all over the world.

LASHBOMB STUDIOS Midvale

Eyelash Extensions Agreement and Consent Form

Please read thoroughly and initial next to each statement:

​LASHBOMB STUDIOS Midvale

Social Media Agreement and Consent Form

​

LASHBOMB STUDIOS Midvale

Policy Agreement

PLEASE GIVE THIS DEVICE BACK TO THE RECEPTIONIST

LASHBOMB STUDIOS Midvale