Lash Consent Form - Alison Andrews Spa (Page 2 of 4) in pdf

Will you be able to keep your eyes completely closed for up to 2 hours? ______ Yes _____No

Are you pregnant? _________ Yes _________ No

What other products do you currently use around your eyes? ( eye creams, oinments, lash

growers, etc.)

_____________________________________________________________________

______________________________________________________________________________

PLEASE NOTE USE OF OIL BASED PRODUCTS AROUND EYES SHOULD BE DISCONTINUED FOR 48

HOURS AFTER YOUR EYELASH EXTENSION SERVICE. It is also recommended to avoid all oil

based products around your eyes for as long as you wear your lashes. Oil based products,

waterproof mascaras and liners will loosen the adhesive and your lashes will not last long.

Please initial and date you read and understand the above. ___________Initial_________Date

For longevity we recommend not to use mascara ( you're lashes will look so glamorous you

won't feel a need to), however if you must, be sure it is oil free and remove it daily with an oil

free wash. We recommend our eye wash, or you can may use Sterild or Occusoft ( available at

most drug stores).

Please initial and date you read and understand the above _________Initial __________Date

Do you use lash growers such as Lattice or over the counter ones? ________Yes ________No

It is best to discontinue use of these 2 weeks before you service and discontinue use while you are

wearing your lash extensions. Some contain oils and/or steriods and will shorten the duration of

your extensions.

How do you usually sleep? _______Side __________Back __________Stomach

Please note you will lose more eyelash extensions on the side on which you sleep. Sleeping on

your stomach will affect them the most and it is important to refrain from sleeping on your

stomach for the first 2 days after your service to allow the adhesive to set properly.

The following conditions are not suitable for eyelash extensions.

Possible adverse reactions are listed below each condition.

Are you allergic to adhesives ( glues, tapes, band aids, etc)? ____________Yes __________No

This service may use adhesives tapes, glues and gel pads thaty may cause an allergic reaction.

We use a medical grade, formaldehyde free glue, but allergies may still occur.

Have you had Chemotherapy Treatments in the last 6 months? _________Yes _________No

Medication for chemotherapy may cause a reaction to the materials used in this service. Also, if

lashes are just starting to grow back they may be a little weak and we recommend waiting until

they are strong enough for this service.

Lash Consent Form - Alison Andrews Spa Page 2