Consent & Release Form Eyelash Extensions

The following information will help you to make an informed decision about whether to proceed with eyelash extension procedures. Please read and complete each section of this consent form.

Eyelash Extensions Per-care, Aftercare, & Possible Risks

• Avoid tinting or perming your natural eyelash hairs for 2 months before you begin eyelash extension procedures.
• No eyelash growth serums for 3 months before you begin eyelash extension procedures.
• Avoid caffeine and alcohol 24 hours prior to your appointment.
• Do not wear eye makeup, eye cream, or contact lenses for your appointment.
• Do not wet lash extensions for 24hour after application.
• Gently wash your lashes every day with foam lash soap and a soft lash brush.
• Brush your lashes daily using a soft spooly brush.
• Oil based products will weaken the adhesive bonding and the eyelash extensions will prematurely fall out. Examples of oil-based products are waterproof makeup, makeup removers, face or body creams, and sunscreen.
• Do not rub, pull, or attempt to remove the eyelash extensions.
• During the eyelash extension procedure, you may experience eye irritation or tearing.
• Rare occasions there are risks associated with wearing eyelash extensions and eyelash extensions applied to or removed from the natural lash hairs.

Eyelash extensions procedure applies a single or fan synthetic eyelash extension to your individual natural eyelash hairs utilizing professional salon adhesive glue and eyelash extensions.

A full set of eyelash extensions should take about 2 hours to accomplish depending on several factors. Eyelash fills should take about 1 to 1.5 hrs. Procedure times vary depending on individual conditions and level of service.

The eyelash hairs growth cycle naturally sheds and replenishes the eyelash hairline 20-30% every 2 weeks. This means 20% to 30% of your eyelash extensions fall out along with your natural eyelash hairs in the growth cycle. We recommend an eyelash fill every 2 weeks.

Eyelash extension that are over 3 weeks from the last fill will require a new full set of eyelash extensions. We will respectfully decline to provide eyelash fill services if our assessment identifies these findings at the beginning of your appointment.  

I agree to have eyelash extensions applied to my natural eyelash hairs and/or eyelash extension fill services, or eyelash extension removal services.

I understand that I will need to remove my contact lenses, I should not wear eye makeup, and I should not use oil-based cosmetic or skin products on the day of my eyelash extension appointment. I understand and consent to having my eyes closed and covered for the duration of the eyelash extension procedure that maybe approximately from 60 to 120 minutes. The procedure time may vary depending on individual variables or level of service and may exceed 120 minutes.

I understand that I should not wet or wash the eyelash extensions for 24 hours after the procedure.

I understand NO Guarantees have been made regarding the bonding time of the eyelash extensions. Standard health precaution guidelines are strictly adhered to. I release Modern Beauty Glam from all liability associated with this procedure.

I have read all the Pre-care/Aftercare guidelines and acknowledge that Aftercare instructions are available on www.modernbeautyglam.com. I agree to follow them to the best of my ability. I understand that failure to adhere to the aftercare recommendations may cause the eyelash extensions to fall out or decrease the wear time of the eyelash extensions. I understand that I should not rub, pull, or attempt to remove the eyelash extensions.

I understand that I should not use oil-based cosmetics or skin products when wearing eyelash extensions. Oil based products will weaken the adhesive bonding and the eyelash extensions will prematurely come off.

I understand that in rare occasions there are risks associated with wearing eyelash extensions applied to or removed from the natural lash hairs. During the procedure you may experience minor eye irritation or tearing.  In rare cases eye itching, eye infection, or eye pain may occur and, if I experience any of these symptoms I will consult with a physician at my own expense.

I grant permission to Modern Beauty Glam, to take and use photographs and/or digital images of me for documentation purposes, use in educational materials and/or social media platforms.

Deposit Policy:

A full set of eyelash extension appointments requires a $75 deposit. This is a non-refundable deposit that will be applied towards the remaining balance of your treatment at check-out. 

Cancellation policy:

We require 48-hour notice for a no fee cancellation. Cancellations less than 48 hours from the appointment time will forfeit the non-refundable deposit and will not be able to transfer the deposit to a later date. Fill cancellations less than 48 hours from the appointment time will incur a non-refundable cancellation fee of 50% of the service procedure and will be charged to the card on file or added to the next service appointment.

Same day cancellation will be charged 50% of the service procedure and forfeit the non-refundable deposit. No call no show will be charged 100% of the service procedure and forfeit the non-refundable deposit.

Late Policy

Please note that we have a 15-minute late policy. Arriving 15 minutes late for your appointment will be considered a no show. We reserve the right to CANCEL and give no refunds if the client is more than 15 minutes late to their appointment. If you are late, you may schedule a new appointment but will need to make a new deposit.

No Refunds

Modern Beauty Glam does not offer refunds, no exceptions.

Anti-Fraud Policies

By signing below, you acknowledge that the credit card or debit card used to book was your card and you are not paying for the service in a fraudulent manner.

If the card being used is NOT yours, you acknowledge that the person paying for you is someone you personally know and has already completed and signed our Credit Card Authorization Form prior to you booking your appointment. If at any time the person paying for this service issues a chargeback, you will be personally liable for the full amount of the chargeback. If there are any unresolved chargebacks, your file will be submitted to Small Claims Court of Broward County.

This agreement will remain in effect for this eyelash extension procedure and for all future eyelash extensions procedures provided by Modern Beauty Glam.

I certify that I have read or have had read to me the contents of this whole form. I understand the risks and alternatives involved in this procedure(s) and I have had the opportunity to ask questions and all my questions have been answered. I acknowledge that I have reviewed and approved the material given to me.

By selecting the "Submit" button, you are signing this Agreement electronically. You agree your electronic signature is the legal equivalent of your manual/handwritten signature on this Agreement.