Eyelash Lift/Tint Consent Form 

I agree to have an eyelash lift and or eyelash tint applied to my natural eyelashes and or retouched. By signing this agreement, I consent to the procedure of an eyelash perm or eyelash tint by my licensed technician.
 
I understand that there are risks associated with eyelash perms and or tints. I further understand that as part of the procedure, eye irritation, eye pain, eye itching, discomfort, and in rare cases eye infection can occur. I agree that if I experience any of these medical conditions with my lashes that I will contact my technician and consult a physician at my own expense.
 
I understand that even though my licensed technician perms the lashes using the proper techniques, the instruments, tapes, cleaners, gel pads, remover’s may irritate my eyes or require a physician’s follow-up care.
 
I understand and agree to the care instructions provided by my technician for the use and after care of my eyelashes. I realize and accept that failing to adhere to these instructions may cause the eyelashes to not stay perm or tinted as long.
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I agree to the following eyelash perm/tint aftercare and maintenance instructions:
 
1.     No water can come in contact with my eye area for 24 hours after application.
2.     I understand that this consent agreement is legal and binding.
3.     I have read and fully understand all information in this agreement.
4.     I release my technician, MAEDA, and its owner from all liability associated with this procedure.
5.     I accept that this service is performed with the utmost attention to safety and proper sanitation and   application, using tools and products that the technician has been professionally trained to use.
6.     I understand that there are no guarantees for the length of time my lashes will stay permed or tinted.

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