Lash Lift Consent Form



I agree to have an eyelash lift (perm) applied to my natural eyelashes and/or retouched. I consent to the procedure of an eyelash perm by my technician.


I understand there are risks associated with having an eyelash perm. I further understand that as part of the procedure, eye irritation, eye pain, eye itching, discomfort, and in rare cases eye infection or blurriness could occur. I agree that if I experience any of these medical conditions with my lashes that I will contact my technician and consult a physician at my own expense.


 I understand that even though my technician perms the lashes using the proper technique, the instruments, tapes, cleaners, eye gel pads, adhesives, and removers used may irritate my eyes or require a physician’s follow-up care. I understand and agree to the care instructions provided by my technician for the use and care of my permed. I realize and accept the consequences of failure to adhere to these instructions may cause the eyelashes to not stay permed as long as told.


There are no guarantees for length of time the lashes will stay permed. I understand the aftercare instructions and will do my part to maintain my eyelashes. I understand that there are many factors that may affect the life of the eyelash lift such as water and moisture contact, weather conditions, and activities involving exposure to high temperatures.


I have read, understand and I consent to the terms of this agreement. By signing below, I assume any risk, harm or injury which may occur as a result from the eyelash lift and I give my permission to my esthetician at SOS WAX and Skincare to perform the services. I will hold the esthetician and SOS WAX and Skincare harmless of any liability and waive any claims that may result from the services.

Who is receiving the Service?

Adult (You)  Minor

Signee Information

If so, please list all (including over the counter drugs / herbal supplements)

Please sign below using your mouse.

By clicking 'I Agree' below, you agree that you have read and agree with the terms of the waiver and that the information you provided is accurate. You furthermore agree that your submission of this form, via the 'I Agree' button, shall constitute the execution of this document in exactly the same manner as if you had signed, by hand, a paper version of this agreement.