Premier Lashes Las Vegas by appoinment only (702)501-2827 www.premierlasheslv.com premierlasheslv@yahoo.

com

Eyelash Extensions Agreement and Consent Form

Premier Lashes Las Vegas ~ ~

Full Name: _______________________________________________________________________ Phone number: ___________________________________________________________________ E-mail : __________________________________________________________________________ Referred by: ______________________________________________________________________ Allergies: ________________________________________________________________________ Asthma or any respiratory problems? _______________________________________________ Sensitivities? (itchy eye,seasonal hay fever etc.)______________________________________ Are you pregnant? (circle one) Yes No

Do you wear contact lenses? ________________________________________________________ Will you remove them during procedure?(circle one) Typo of eye makeup remover and mascara? _________________________________________ Prior Eyelash Extension Experience? _______________________________________________ Yes No

Premier Lashes Las Vegas by appoinment only (702)501-2827 www.premierlasheslv.com premierlasheslv@yahoo.com

What do you expect from your eyelash extensions? Style,Length etc. __________________________________________________________________________________ Initial
_________ I understand that this procedure requires single synthetic eyelashes to be glued to my own natural eyelashes. I understand that it is my responsibility to keep my eyes closed and be still during the entire procedure, until my eyelash technician addresses me to open my eyes. I understand that some risks of this procedure may be but not limited to eye redness and irritation. The fumes from the adhesive may cause my eyes to tear up if I open my eyes. _________ I agree to disclose any allergies that I may have to latex, surgical tapes, cyanoacrylate, Vaseline, etc. I will seek medical care (at my own expense) and contact Premier Lashes Las Vegas immediately if any allergic or adverse reaction occures. All of my questions were answered and I understand the procedure and risks. _________ I understand that I am required to follow the eyelash extension care sheet in order to maintain the life of these extensions. I understand that eyelash extensions require ongoing maintenance (Refill every 1-3 weeks). If I wait too long between Refills, I may need to pay for a new full set. If I no longer wish to wear the eyelash extension, my technician will remove them and I will not try to remove them myself. _________ I grant permission to Premier Lashes Las Vegas to use my before and after photos for marketing or examples of Premier Lashes Las Vegas work. (Photos are a permanent part of Premier Lashes Las Vegass records, you may opt out) _________ I agree that by reading and signing this consent form, I release Timea Owsley and Premier Lashes Las Vegas from any claims or damages of any nature. I agree that I read and fully understand this entire consent form. I am of sound mind and fully capable of executing this waiver form myself. _________ I understand that this procedure has many variables due to lifestyle, moisture, weather, extreme temperatures, natural eyelash shedding, and other factors. The technician will assess and decide if I am a candidate for this service to the best of their ability. No guarantees are made or implied. For single - strand Eyelash extension services, the undersigned agrees to pay ______ $

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________________________ TECHNICIAN

Premier Lashes Las Vegas by appoinment only (702)501-2827 www.premierlasheslv.com premierlasheslv@yahoo.com

Notes: Eyelash Extensions After Care ~

Eyelash extensions are not for everyone. This is very high maintenance beauty treatment. It requires very gentle care in order for the lashes to last long and stay in good condition. once the lashes are attached you must not rub or pull on them, this could damage your own natural lashes. You must not use any oil based mascara, make up remover, lotion, cream etc on your eylashes or eye area. you should read and understand all the information below, and sign the form before you get this service done. __________ initial WHAT ARE EYELASH EXTENSIONS? Eyelash extensions are individual Synthetic material. Tehy are attached to your natural eyelash individually, not to the skin. each synthetic lash is attached to an eyelash. it is a very enhancing beauty sercive wich requires skill and precision. Once applied these lashes are so natural looking it is difficult to tell even up close that you have extensions on. They are availanle in different thickness, lenght, curl and color. _____________ initial HOW LONG DO EYELASHES LAST? It is an individual process. We lose one eyelashe almost every day. we also grow a new lash to replace the one that fell out. Eyelash extensions can stay on up to 5-8 weeks with proper care and maintenance. However, factors such as eyelash growth, lifestyle and general after care will affect how long the lashes last. Please do not attempt any lashes on your own, seek professional help to remove them. Timea Owsle and Premier Lashes Las Vegas will not be held liable for any damage that you may cause by trying to remove the eyelash extensions on your own. We offer home care products that will help you extend the life of your new lashes. ___________ initial DO THE EYELASH EXTENSIONS DAMAGE MY NATURAL LASHES? No, not at all!! the lash adhesive is formulated to create a solid bond, specifically for human lashes. The adhesive dries very soft on the lashes, allowing the lashes to stay flexible and bouncy just like your own lashes. WHAT SHOULD YOU DO BEFORE YOUR EYELASH EXTENSION APPOINTMENT? Remove all eye makeup and clean your lashes with mild, oil free cleanser. (if possible do not wear any makeup 4-8 hours before your appointment). Do not use oil based makeup removers to clean your lashes prior to application (oil can repel eyelash adhesive). Do not put on mascara. Time spent on cleaning of make up / mascara will shorten the application time. If you are a contact lens wearer, please remove your contact lenses and wear glasses to your appointment. Plan to set aside 1-3 hours for your appointment (depending on choosen style).
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Premier Lashes Las Vegas by appoinment only (702)501-2827 www.premierlasheslv.com premierlasheslv@yahoo.com

Bring your music player with headphones, lay back and relax. Most of our clients use this time to take a nap. ____________ initial

WHAT HAPPENES IS A LASH SHOULD LOOSEN OR BECOME DISLODGED? Do not pull on the lash. Please contact your technician to make an appointment to have them removed or replaced to avoid damage to your natural lashes. As your natural lashes fall out due to the growth cycle, you will need refills when new lashes grow. At first you may find you need a refill every 2 weeks. As you become accustomed to the extensions and with a little practice maintaining the lashes, the time between refills can be extended to 3-4 weeks. We recommend you to book your refill appointment in advance so your spot is guaranteed in the timeframe. ______________ initial 1. Do not perm or Tint lashes before or after lash extension application 2. Do not use a regular eyelash curler. This will break your lashes half. 3. Do not rub your eyes or lashes when washing your face. Clean around the eyes with care 4. Do not pull your lash extensions, as it will take out your own lash as well 5. Do not go in a Sauna while wearing eyelash extensions 6. Do not use regular mascara. We do offer special mascara and eye pencil that was designed to be used with eyelash extensions. 7. Do not use oil based products on your lashes 8. Do not try to remove the extensions on your own 9. Do not cut the extensions, you may cut your own lashes 10. Do use products that are specialy made for eyelash extensions (makeup remover, mascara etc) 11. Remember to come in for touch ups

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