No water can come in contact with the eye area for 24 hours after the application. There are no guarantees for length of time the lashes will stay permed. I understand the aftercare instructions and will do my part to maintain my eyelashes. I understand that there are many factors that may affect the life of the eyelash lift such as water and moisture contact, weather conditions, and activities involving exposure to high temperatures.
I have read and understand the above
Aftercare Instructions:
- • Don't get lashes wet for first 24 hours
- • Don't use oil based eye products, creams or waterproof mascara
- • Use only water based make up and make up remover
- • Remove make up around the eye with a cotton swab
- • Gently brush lashes daily with a lash brush
I have read and understand the post-treatment home care instructions. I am willing to follow recommendations made by my esthetician for a home care regimen that can minimize or eliminate possible negative reactions.
I have read and understand the above
Medical History
Check all that apply:
Please list any medications you're currently taking:
Please list any known allergies or sensitivities:
Please list any other illnesses/conditions you are currently being treated for by a medical professional, or any other medical condition we should be aware of (fever, common cold, infection, etc.):
What skin care products do you use?
Have you ever had a topical skin reaction? If so, what did you react to?
Please list any other conditions which would prohibit or compromise the process and retention of this eyelash perm:
Policy Disclosures
Please check each policy to state that you read and understand the policy:
I understand that any missed/cancelled appointments without 24 hour notice will result in charge of the full amount of the service and will be charged to the credit card I have provided on file (non-members), gift card, or my Valley membership (members only).
I have read and understand the above
I have accurately answered the questions above, including all known allergies, prescription drugs, conditions, or products I am currently ingesting or using topically
I have read and understand the above
I take it upon myself to keep the esthetician updated on my physical health
I have read and understand the above
I understand that if I have any concerns, I will address these with my esthetician.
I have read and understand the above
Please sign to state that you read and understand the policy
I give permission to my esthetician to perform the procedures we have discussed. I agree to hold harmless the The V Spa, its employees and agents for any liability that may result from this treatment and/or for any of my conditions that were present but not disclosed at the time of this service. I have accurately answered the questions above, including all known allergies, prescription drugs, conditions, or products I am currently ingesting or using topically. I understand my esthetician will take every precaution to minimize or eliminate negative reactions as much as possible. I understand that estheticians do not diagnose illness, disease, or other medical, physical, or emotional disorders or prescribe medical treatment or pharmaceuticals. It has been made clear to me these services are not a substitute for medical examination or diagnosis and that I am responsible for consulting a qualified physician for any physical ailment I might have. I certify that I have read, and fully understand, the above paragraphs and that I have had sufficient opportunity for discussion to have any questions answered. I understand the procedure and accept the risks. I agree that this constitutes full disclosure, and that it supersedes any previous verbal or written disclosures. I also affirm that I am at least 18 years of age, or have parental consent to receive my services today (if under 18, parent or guardian signature must be present).
