Client Intake and Release Form
By scheduling your appointment at Lash Lift RI, you authorize us to perform the service you have selected. You acknowledge that it is your responsibility to remain still and keep your eyes closed throughout the procedure, unless otherwise instructed.
You understand that the eyes and surrounding skin are extremely delicate and that potential risks include irritation, burning, or allergic reactions to the products used during the lash lift process, including (but not limited to) tape, cleansers, gel patches, lotions, adhesives, eyelash tint, or developer. These reactions can range from mild irritation to a more severe allergic response.
You confirm that the methods, procedures, and potential risks associated with the service have been fully explained to you, and that you understand and accept these risks prior to proceeding.
While it is not possible to list every potential risk or complication, certain conditions may impact the outcome of your lash lift service. Please inform us if you currently have, or have a history of, any of the following:
Eye infections or disorders
Allergies to cosmetics or beauty products
Very sensitive eyes
Styes or a history of styes
Dry Eye Syndrome
Excessively watery or twitching eyes
Recent eye surgery
Conjunctivitis (pink eye)
Pregnancy (first trimester)
Use of Thyroxine (may affect lash curl results)
Chemotherapy treatment
Hay fever or chronic watery eyes
Blepharitis
Use of prescribed or medicated eye drops or lotions
Current or past use of Retin-A or similar skin products
Disclosing this information helps us determine whether the service is appropriate and ensures your safety and best possible results.
If at any time you feel uncomfortable with the service, you will inform the technician in order to rectify the problem, including ending the session if you or the technician determine it is necessary. It has been represented to you that no guarantees, warranties, promises, commitments or other statements as to the results of this treatment have been made. You acknowledge that you have no particular representation or guarantees and are consenting to the procedure at your own risk. All conditions must be revealed or disclosed to the technician regarding your health history, medications being taken and any past reactions to products used or medications taken. Additional conditions could be discovered during the procedure, which could affect your ability to tolerate the procedure.
By scheduling an appointment, you acknowledge and agree to release and forever discharge Lash Lift RI LLC, along with any affiliated individuals, partners, corporations, or related entities, from any and all claims, liabilities, or damages of any kind.
You further agree to hold Lash Lift RI LLC harmless from any and all claims or damages. You release the company from responsibility for any pre-existing conditions that you have not disclosed, as well as for any changes or complications related to those conditions that may arise after the procedure.
You accept full responsibility for any risks or complications that may occur during or after the services performed at your request.
You voluntarily request and consent to having these procedures performed without first receiving a sensitivity (patch) test. You understand that a patch test, if performed, could help determine any potential sensitivity or allergic reaction to the products used.
By scheduling an appointment, you confirm that you have read and agree to the full Client Intake Form (Client Intake: https://www.lashliftri.com/clientintake). You confirm that you have read and understand the contents of this form and accept full responsibility for your decision. By doing so, you release and absolve all other parties involved in providing the products and services from any related liability, to the fullest extent permitted by law.
As the client, you consent to the taking of “before and after” photographs for documentation purposes. You understand that these images may be used for advertising and promotional purposes. Additionally, you agree to receive appointment-related emails and occasional newsletters.
