Eye-Lash Consent Form | Blinks And Brows Boutique

I hereby inform the certified eyelash professional of the following conditions by marking with a check: Required

Current use of contact lenses which I agree to remove during eyelash application

Current use of eyedrops of any kind, prescription or over-the-counter for dry eyes (Sjogren’s Syndrome)

Current use of anything such as oil-containing sunscreen or moisturizers around the eyes

Current allergies or sensitivities to instruments, fumes, tapes, cleaners, eye gel pads, adhesives, and removers that could cause my eyes to water and blink in excess

History of claustrophobia or anxiety.

History of recurrent eye or tear duct infections

Recent history of Chemotherapy. Please mention the date in comment section underneath.

Other medical conditions which would prohibit or compromise placement and retention of eyelash perm or tint. Eg; Lasik

None of the Above

Eyelash Extension and Tint Consent Form

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