Lash and Brow Tint Form

I understand that a patch test is recommended prior to tinting treatments. I have chosen to proceed without a patch test and accept the risk of a potential allergic reaction OR I confirm that I have received a patch test at least 24–48 hours prior to treatment and have experienced no irritation, redness, itching, swelling or discomfort.

I understand that I need to remove any contact lenses prior to treatment

I understand that in order to have a tint, I will need to keep my eyes closed for around 15-30 minutes in a reclined position. Any medical conditions that might be aggravated by lying still for a prolonged period of time may mean that I will not be able to have the procedure performed on my eyes.

This agreement will remain in effect for this procedure and all future lash lifts at Iris Avenue. I understand this agreement is binding and that I have read and fully understood all the information above. I represent that I am over the age of 18 years old.

Please select any of these that apply to you:

Reaction to Patch Test

Cysts

Chemotherapy

Skin Disease

Watery eyes

Conjunctivitis

Weak eyelashes at therpist discretion from previous prodct use

Alopecia

Skin Disorders in the general eye area

Recent operation to eye

Eye inflammations such as Uveitis or Keratitis