The Beauty QTique
2311 Calvert St. NW Washington, DC 20008 2nd floor
Service Consent Forms
Click to view the consent form coinciding with your service: Eyelash Extensions, Eyelash and Brow Tint, Eyelash Lift
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: (by checking the box on your booking form is equivalent to your initials on this form)
_____ 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.
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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 KEYLA ANDREWS or THE BEAUTY QTIQUE 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.
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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.
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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 skin care procedure, which may be affected by the treatment performed today.
I acknowledge this agreement for all lash lift services received within a year from signing date.
By checking the box on the booking form is the equivalent of your signature.
Eyelash and 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: (by checking the box on your booking form is equivalent to your initials on this form)
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_____ 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.
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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 KEYLA ANDREWS or THE BEAUTY QTIQUE harmless from any liability that may result from this treatment.
I have accurately answered the questions on the Booking 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.
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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 skin care procedure, 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 signing date.
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By checking the box on the booking form is the equivalent of your signature.
Eyelash Lift Consent Form
Although every precaution will be made to ensure your safety and well-being before, during, and after your lash lift application, please be aware of the possible risks below.
Please initial: (by checking the box on the booking form it is the equivalent of initialing)
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_____ I understand that having my eyelashes lifted or permed may have some risk of irritation to the orbital eye area, including, but not limited to the eye itself. If solution 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 lash lifting agent gets in my eye, then my eye will be flushed with sterile eyewash and medical attention may be required.
_____ I understand that, while every attempt will be made to provide me with my chosen degree of lash curl, there are many factors on how hair absorbs the solution and my results may not be the curvature I initially requested.
_____ I understand that natural eyelashes have a growth cycle and my natural eyelashes grow and shed. Receiving consistent lash lifts is required to keep the lifted appearance. I understand that maintenance is recommended every 6-8 weeks.
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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 KEYLA ANDREWS or THE BEAUTY QTIQUE harmless from any liability that may result from this treatment.
I have accurately answered the questions on the Booking 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 skin care procedure, which may be affected by the treatment performed today.
I acknowledge this agreement for all lash lift services received within a year from signing date.
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By checking the box on the booking form is the equivalent of your signature.