Informed Consent Form Eyelash Extensions
This site contains relevant information to the eyelash extensions procedure. It is not intended to represent the current consent form which is produced at the time of booking relevant to the most updated version.
All services are performed by a specialised, qualified and experienced technician who will exercise the upmost care in the delivery of your treatment. Your health, safety and well-being is our number one priority and will be held paramount when making decision regarding your suitability for a service.
To establish the implied consent to the treatment you booked translates to fully informed consent the key information about the services we offer is outlined below. Please read all of the general information and the procedure information relevant to your chosen services carefully.
Attendance at your appointment indicates your acceptance of all terms and reflects your informed decision to proceed.
1. Information for All Services
1. 1 PATCH TESTING
- I understand that for reasons including;
- genuine allergic reactions typically take place up to 48 hours post-exposure
- sensitivities can develop at any time despite laying dormant for years
- reactions generally will not occur when exposure to small amounts of an allergen in the same way they will when a full procedure is carried out
- that any “patch test” involving one of a range of active ingredients which may be carried out would not necessarily be conclusive or accurate.
- Despite these points I understand a Patch Test is readily available to me should I wish to undertake one. I understand it is my responsibility to alert and request one from my service provider at my earliest convenience to abide by the bookings timeframe policies.
- Alternatively, I agree to proceed with full knowledge of the potential risks or any rare allergic reactions which may occur.
1. 2 DISCLOSURE
- I do not have any known condition, medical or other, which may be aggravated by or affect your ability to safely receive this treatment.
- I do not have any known allergies to adhesives, synthetics, tape and have not had a previous reaction to this treatment.
- I understand my technician may request permission to take non-identifying, before and after photos of the procedure. If I consent I grant the use of these images for education and advertising or other purposes.
1.4 LIABILITY WAIVER
- I understand by proceeding with my appointment I release Perth Tan Lash & Beauty Pty Ltd & Dayiman Pty Ltd from any and all claims, actions, expenses, damages and liabilities, including reasonable legal fees which might be asserted against them as a result of my having this procedure performed, or my purchase of any of their products. As used in this agreement, the term Perth Tan Lash & Beauty Pty Ltd & Dayiman Pty Ltd include all of their respective, directors, agents, employees, contractors successors and assigns
- I understand my consent will remain in effect for the procedure and all future procedures and it is my responsibility to inform my technician of any relevant changes.
2.0 Eyelash Extensions
2.1 THE PROCEDURE
- I understand all eyelash extension treatments involve the attachment of individual extensions formulated from synthetic fibres to my own natural eyelashes using medical grade adhesive.
- I understand the full set of extensions procedure time will be 60 minutes or upwards. It is my responsibility to keep my eyes closed and be still in a reclined position during the entire procedure. The fumes from the adhesive may cause my eyes to become irritated particularly if I open my eyes before directed.
- I understand protecting the health, growth and appearance of your natural eyelashes will be held paramount when decisions regarding my suitability for the service are made
2.2 CONTRA INDICATIONS
- I understand there is a risk eyelash extension adhesive may get underneath contact lenses and cause corneal abrasion or scratching. To avoid this risk contact lenses need to be removed prior to the treatment.
- I understand in some cases laser eye surgery may cause sensitivity to eyelash extensions or lash lift products. These treatments should be avoided for four weeks after surgery. I will consult my own doctor if this applies to me.
- I understand medication for chemotherapy may increase the risk of a reaction to this procedure and will consult my doctor if I have had this treatment within the last six months.
- I acknowledge it is impossible to list all of the potential risks or side affects but some of these are listed below.
- I understand in rare cases an individual may be allergic or hypersensitive to the materials used causing side effects including but not limited to eye redness, discomfort and irritation.
- I acknowledge there are rare but potentially harmful or negative side effects (such as the premature shedding of natural lashes) that the lash procedure or removal may cause to those who have specific medical or skin conditions.
- I agree that if I experience any of these rare side effects or issues I will contact my technician and if required consult a physician at my own expense.
- I understand that every care is taken but should an extremely rare allergy or reaction occur this is unforeseeable and no refunds will be issued. With the approval of the clients medical practitioner a free removal will be offered in these circumstances
2.4 CLIENT RESPONSIBILITIES
- I understand careful aftercare is required to maintain eyelash extensions and these instructions will be outlined. Any follow up care or reduced life of the extensions caused by failure to follow these instructions will be at my own expense and risk.
- I understand I need to engage with my technician during the initial consultation so clear expectations can be set as all service sales are final and non refundable.
- I agree to contact the service provider as soon as possible (within 3-4 days) should any issues arise post service so they can work with me to rectify any issues as all service sales are final and non refundable.
- I understand the cancellation policy as outlined during the booking process and that any changes or cancellations to booked treatments forfeit the required deposit at a minimum regardless of whether or not this was paid at the point of booking.
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