Release Forms

Due to the 2019-2020 outbreak of COVID-19, we are taking additional precautionary steps mandated by the state of WA in sanitation and safety practices. I understand the following symptoms and affirm that I, as well as all household members, do not currently feel nor have experienced the listed symptoms within the last 14 days. • Fever • Dry Cough • Sore Throat • Chills or Shaking • Shortness of Breath or Difficulty Breathing
_____ I affirm that I, as well as all household members, have not been diagnosed with COVID-19 within the last 30 days. _____ I affirm that I, as well as all household members, have not knowingly been exposed to anyone diagnosed with COVID-19 in the last 30 days. _____ I affirm that I, as well as all household members, have not traveled outside of the country, or to any city outside of the eastern wa/idaho, that is considered a “hot spot” for COVID-19 by the Centers for Disease Control and Prevention within the last 30 days. _____ I understand that it is my responsibility to refrain from touching my face throughout the appointment. _____ I understand that it is my responsibility to wear a mask throughout the duration of my time in the building and to wash my hands upon arrival.
I have read the above information. If I have any concerns, I will address these with my stylist immediately. I hold Liberty Lake Lashes harmless from any liability for the unintentional exposure to bacteria, viruses, or other microorganisms that may cause illness or disease. I have accurately and honestly completed this form as well as the Client Intake Form. I understand my stylist will take every precaution to minimize or eliminate the spread of microorganisms within the studio. If I have additional questions or concerns throughout the appointment, I will consult my stylist immediately. I agree that this constitutes full disclosure, and that it supersedes any previous verbal or written disclosures. I certify that I have read, and fully understand, the above paragraphs and that I had sufficient opportunity for discussion and all my questions are answered. I accept the risks that may be associated with public interaction.
Eyelash Extensions Consent Form Although every precaution will be made to ensure your safety and well-being before, during, and after your eyelash extensions application, please be aware of the possible risks below. Please initial: _____ I understand that having eyelash extensions applied may have some risk of irritation to the orbital eye area, including, but not limited to the eye itself. Some cases may result in eye redness, a stinging or burning sensation, blurred vision, irritation, or allergic reaction to the adhesive, under eye patches, or other products used. _____ I understand that it is my responsibility to remain still during the application and to keep my eyes closed unless otherwise advised. _____ I understand that if any solution gets in my eye, then my eye will be flushed with sterile eyewash and medical attention may be required. _____ I understand that natural eyelashes have a growth cycle and my natural eyelashes grow and shed. Receiving consistent refills is required to keep the full appearance and protect the integrity of the natural eyelashes. I understand that maintenance is recommended every 2 weeks. _____ I understand that for the purposes of documentation “before and after” photographs will be taken. These photos are kept in my file and not shared without my permission. _____ I give LIBERTY LAKE LASHES permission to use photographs taken of me for advertisement purposes or portfolio development. (Optional) I have read the above information. If I have any concerns, I will address these with my stylist immediately. I give permission to my stylist to perform the tinting procedure we have discussed and will hold (Stylist Name) or LIBERTY LAKE LASHES harmless from any liability that may result from this treatment. I have accurately answered the questions on the Client Intake Form, including all known allergies, prescription drugs, or products I am currently ingesting or using topically. I understand my stylist will take every precaution to minimize or eliminate negative reactions. If I have additional questions or concerns regarding my treatment, I will consult my stylist immediately. I agree that this constitutes full disclosure, and that it supersedes any previous verbal or written disclosures. I certify that I have read, and fully understand, the above paragraphs and that I had sufficient opportunity for discussion of the process and all my questions are answered. I understand the service and accept the risks. I do not hold the stylist, whose signature appears below, responsible for any of my conditions that were present, but not disclosed at the time of this eyelash extension service, which may be affected by the treatment performed today. I acknowledge this agreement for all eyelash extension services received within a year from the signing date. Client Name (Printed): Client Signature: Date: Service Provider Signature: Date:
Lash & Brow Tint Consent Form Although every precaution will be made to ensure your safety and well-being before, during, and after your tinting application, please be aware of the possible risks below. Please initial: _____ I understand that tinting my eyelashes or eyebrows may have some risk of irritation to the orbital eye area, including, but not limited to the eye itself. If tint enters the eye, it can result in a stinging or burning sensation, blurred vision, and in severe cases blindness if the eye is not immediately flushed. _____ I understand that if the tinting agent, developer, or mixture of both gets into with my eye, then my eye will be flushed with sterile eyewash and medical attention may be required. _____ I understand that if the tint encounters the skin, then irritation or a sensation of itching or burning may occur. _____ I understand that there may be some residual tint staining left on the skin following the tinting process of either my lashes, brows, or both. I understand that this fades away. _____ I understand that, while every attempt will be made to provide me with my chosen color, there are many factors on how hair absorbs color and my results may not be the color I initially requested. _____ I understand that over the course of several weeks, the tint will gradually lighten and fade. I understand that natural eyelashes have a growth cycle and my natural eyelashes grow and shed. Re-tinting is required to keep the intensity of the color. I understand that maintenance is recommended every 3-4 weeks. _____ I understand that for the purposes of documentation “before and after” photographs will be taken. These photos are kept in my file and not shared without my permission. _____ I give LIBERTY LAKE LASHES permission to use photographs taken of me for advertisement purposes or portfolio development. (Optional) I have read the above information. If I have any concerns, I will address these with my stylist immediately. I give permission to my stylist to perform the tinting procedure we have discussed and will hold (Stylist Name) or LIBERTY LAKE LASHES harmless from any liability that may result from this treatment. I have accurately answered the questions on the Client Intake Form, including all known allergies, prescription drugs, or products I am currently ingesting or using topically. I understand my stylist will take every precaution to minimize or eliminate negative reactions. If I have additional questions or concerns regarding my treatment, I will consult my stylist immediately. I agree that this constitutes full disclosure, and that it supersedes any previous verbal or written disclosures. I certify that I have read, and fully understand, the above paragraphs and that I had sufficient opportunity for discussion of the process and all my questions are answered. I understand the service and accept the risks. I do not hold the stylist, whose signature appears below, responsible for any of my conditions that were present, but not disclosed at the time of this tinting service, which may be affected by the treatment performed today. I acknowledge this agreement for all eyelash and eyebrow tinting services received within a year from the signing date. Client Name (Printed): Client Signature: Date: Service Provider Signature: Date: