Lash Dolls Client Consent & Medical Form

Before you can receive services at Lash Dolls Milwaukee, LLC - you must complete this form entirely.

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* 1. Full Name

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* 2. Email Address

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* 3. Phone Numer

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* 4. I am aware and fully understand that my Credit Card number was placed on file when booking my appointment and that it has not been charged.
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* 5. I am aware and fully understand that I must give 48 hours notice if I need to cancel or reschedule my appointment - otherwise, my card on file may be charged for (no less than 50% of the service and no more than 100% of the service).
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* 6. I am aware and fully understand that if I am a no call/no show that my card on file will be charged for the full amount of the service booked.
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* 7. I am aware and fully understand that if my card declines - that I am still responsible for the cancellation fee and it must be paid within 24 hours.
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* 8. I understand that there are no refunds, but a complimentary removal will be given with 24 hours.
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* 9. I understand that if I am late to my appointment, that I will not get the full amount put on, but am still responsible to pay the full amount.
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* 10. I will not wear eye makeup, mascara or contacts to my appointment.
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* 11. Have you ever had Lash Extensions?

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* 12. If you currently have lash extensions, when is the last time that you had a fill?

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* 13. How would you describe your natural lashes?

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* 14. What type of look are you wanting?

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* 15. Have you ever had an allergic reaction to lash extensions before?

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* 16. List any allergies that you have.
If NONE please type "none".

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* 17. List any medications you are currently taking.

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* 18. Most clients take this time to nap while they are getting lashed. Talking can impede the process if the head and eyes are moving. We recommend no caffeine before appointment so you can relax. 
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* 19. Check ALL that apply

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* 20. I authorize Lash Dolls Milwaukee, LLC and their Lash Artists to apply eyelash extensions on to me.

I understand that I must keep my eyes closed and remain still during the procedure, which can be 90-150 mins.

Some cases may result in complications such as eye redness, irritation, or allergic reactions. If at any time I feel uncomfortable with the procedure such as burning or irritation I will inform my Lash Artist and she/he will make adjustments and/or stop the procedure.

I understand that eyelash extensions require careful maintenance and that if I want to maintain my lashes, I must come in every 2 to 3 weeks for a fill.

I understand that I am not suppose to wear mascara.

I understand that it takes up to 12 hours for the adhesive to cure and I won’t get them wet in that time frame.

*Steam, heat, friction and sleeping on sides or stomach may weaken the bond and create premature lash extension loss.

I understand that oil based cosmetics as well as mascara will weaken the bond. Manual curlers will break the lashes off.

I understand and agree to follow the aftercare instructions that will be given and explained to me at my initial appointment.

I, as herein signed, release, give up, acquit and discharge Lash Dolls Milwaukee, LLC and their Lash Artists from any claims or damages of any nature. 

SIGN FULL NAME

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* 21. Date/TIme

Date / Time

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