Lash Lift & Tint Consent

Solicitud

I, (print name) ______________________, am requesting and consent to have "Joselin ortega / JM STUDIO & SPA LLC" perform a lash lift and/or lash tint on my eyelashes (check one) with or without undergoing a sensitivity patch test by "Joselin Ortega / JM STUDIO & SPA LLC".

Precautions — cada punto requiere iniciales

1. I agree to hold "Joselin Ortega / JM STUDIO & SPA LLC" harmless if I decline a patch test.
2. I understand the risks associated with the lash lift and tint service.
3. I understand that with this procedure I may experience skin or eye irritation, eye pain, eye itching, discomfort, or swelling.
4. I understand that my eyelashes may react to this service and I may experience under curling, over curling, over pigment or lack of pigment, or damage to the natural lashes. I agree that if I experience any of these issues, I will contact "Joselin Ortega / JM STUDIO & SPA LLC" and consult a physician at my own expense.
5. I agree to follow the care instructions provided to me by "Joselin Ortega / JM STUDIO & SPA LLC" for the care of my lifted and/or tinted lashes.
6. I understand that there is no guarantee of how long my lashes will remain tinted or curled.
7. I understand I may not wear contact lenses during the procedure. They must be removed prior to the start of the procedure.
8. I understand I must not wet, steam, or put on mascara for at least 24 hours after the service is performed.
9. I understand that in order for "Joselin Ortega / JM STUDIO & SPA LLC" to perform a lash lift and/or tinting service, I will be required to keep my eyes closed for a duration of 30-40 minutes. I understand that if I sustain an injury due to opening my eyes during the treatment, I will hold "INSERT Joselin Ortega / JM STUDIO & SPA LLC" harmless.
10. I understand that I will be lying in a reclined position and if I have a medical condition that might be aggravated by lying still for this period of time I will inform "Joselin Ortega / JM STUDIO & SPA LLC" of such condition and will not be able to have the lash lift and/or tint performed to my eyelashes.
11. This agreement will remain in effect for the procedure and all future reoccurring procedures of the same nature.

Acuerdo final

I understand this agreement is binding and that I have read and fully understand all information listed above. I represent that I am over the age of 18 or if under the age of 18, I have a parent and/or guardian signature below and that he/she consents to this procedure under these terms. I have completed this form to the best of my ability and knowledge and agree to inquire about questions I may have before "Joselin Ortega / JM STUDIO & SPA LLC" begins performing the procedure. I have been informed of and understand the contraindications to the requested treatments and agree that I do not have any condition(s) that would make the requested treatment unsuitable. I will inform my esthetician of any discomfort I may experience during the requested treatment to allow them to adjust accordingly. I agree to waive all liabilities toward my esthetician and "Joselin Ortega / JM STUDIO & SPA LLC" for any injury or damages incurred due to any misrepresentation of my health history.

• Signature.
• Date.

Nota de fidelidad: INSERT Joselin y reoccurring aparecen así en la fuente.