Consent Form

In order to book for a full set, know that you are responsible for booking your own lash refills according to your lash cycle. I am a busy lash artist and my appointment system is open up to 4 weeks ONLY. If I am not available on my booking system for any refills, book with the Tora Team at torahouseofbeauty.com. If you get a lash refill outside of the Tora Team, please know that you are required to book a full set or ‘other salon’s work’ when you come back.

Read the FAQ on my website to get educated on lash extensions.

First Name

Last Name

Email

Phone Number

Date of Service

I understand that it is my responsibility to keep my eyes closed and still during the entire procedure, until Kim Nguyen tells me I can open them. 

I agree

I confirm and agree to engaged the services of KIM NGUYEN to apply my eyelash extensions.

I agree

I understand that this procedure requires single synthetic eyelash to be glued to my own natural eyelashes. 

I agree

I understand that there are some risks of this procedure may be not limited to eye redness and irritation. The fumes from the adhesive may cause my eyes to tear up when I open my eyes. 

I agree

Adhesives used to apply eyelash extensions have the possibility of getting underneath contact lenses and may cause corneal abrasion or scratching. I understand that contact lenses must be removed prior to my eyelash extension procedure.

I agree

I agree to disclose any allergies I have to latex, surgical tapes, cyanoacrylate, vaseline, etc.  Please disclose any health/allergies. If you have any allergies below, please contact me.

I agree

Conditions

Allergies to adhesives, glues, tapes, bandaids, etc.
Eyelash extensions use adhesives, takes, glue, and gel pads that may cause an allergic reaction.

Chemotherapy treatments within the last 6 months
Medication for chemotherapy may cause a reaction to the materials used for eyelash extensions.

Thyroid medications
Eyelash extensions will not last due to the medication.

Lasik surgery within the last 4 months
Eyes may have sensitivity to eyelash extensions and products used for prepping the eye area (glues, gel pads, etc). Please ask your doctor 4 weeks post-op for approval.

Blepharoplasty
Eyes may have sensitivity to eyelash extensions and products used for prepping the eye area (glues, gel pads, etc.). Please ask your doctor 6 months post-op for approval.

Extremely oily skin and hair
Natural oils will break down the adhesives used to bond the eyelash extensions causing the eyelash extensions to fall out.

If you have any of the conditions listed above, list them here. If none, leave this field blank.

Kim Nguyen is an independent contractor that works at Tora House of Beauty. I agree by reading and signing this consent form, I release Kim Nguyen and Tora House of Beauty from any claims or changes in any of the nature. 

I agree

NO REFUNDS if there is any irritation, Kim Nguyen can remove the lashes and you must follow up with doctor visit if symptoms occur.  *

I agree

To make an appointment:
A NONREFUNDABLE Booking Fee will be collected for each appointment.

Booking Fee Policy/Rebooking Policy
Booking Fee will be credited towards your services.
All booking fees are NONREFUNDABLE:
– 15 minutes late (appointments will be cancelled)
– No Shows & Last minute cancellation
– You must pay another booking fee to book another appointment
Please allow a 24-hour notice for changing appointments.

What is a booking fee?
It is a fee to secure your appointment time, which will be credited towards your day of service.
Why are booking fees nonrefundable or transferable?
This secures our time and yours. So when appointments are cancelled last minute (24-hour time frame), we are not able to fill the slot. Therefore, we lose money and the convenience of booking another client.

Booking Fee Policy/Rebooking Policy

I understand that emergencies happen which is out of our control. I understand to give Kim a 24-hour notice if I need to move my appointment. I understand that it is hard for Kim to fill the last minute appointment that I have canceled. I understand that Kim is an independent contractor and will lose income. I understand that I will lose my booking fee.

I have read and agreed to the Booking Fee Policy/Rebooking Policy

I agree to silence my phone and refrain from answering phone calls during my service.

I agree

All services are performed on time. Please come a few minutes earlier if you need to use the restroom.
Chewing gum is prohibited.
Text us when you arrive and wait in your car until you are alerted to come in. Your stylist will open the door for you.
Thank you for choosing me to be your lash artist.

Electronic Signature

Kimmelashes

Online Lash Consent Form

What is a booking fee?

Why are booking fees nonrefundable or transferable?