Date Of Appointment (Month/Date/Year) Full Name Date of Birth (Month/Date/Year) Address City State Zip Email Home Phone Work Phone Pls select your preferred method of communication for future appointment confirmation: - Select - Phone Call Email Text Please Initial to Confirm You have Read/Understand each of the following Instructions I agree to use only recommended products on my NOVALASH Eyelash Extensions. You must agree before submitting. I understand that I should not get my NOVALASH Eyelash Extensions wet within in the first 24 hours after application. You must agree before submitting. I understand that there are many variables including technician expertise, natural lash growth cycle, use of cosmetics and skin care products, and the overall maintenance given that will influence how long my NOVALASH Eyelash Extension remain in place. You must agree before submitting. I acknowledge that I should not pull on my lashes after they have been applied. You must agree before submitting. I understand that if NOVALASH Eyelash Extensions are not applied properly by a certified extensionist, there is a risk of eye damage and harm to my vision. You must agree before submitting. I understand that there is a possibility of allergic reaction – as with all cosmetic product. You must agree before submitting. Please list any known allergies I have been advised that using mascara on a regular basts will shorten the length of time my extensions remain in place. I have also been advised not to use waterproof mascara on my NOVALASH Eyelash Extensions. You must agree before submitting. I understand that touch-up appointments may be necessary as soon as two weeks after the application and that there may be additional fees for this procedure. You must agree before submitting. I have read and discussed the above information with my NOVALASH Certified Eyelash Extensionist. You must agree before submitting. I have requested treatment at The Day Spa using CryoClear on sun spots, age spots/or skin tags. I understand that the practice of aesthetic medicine is not a precise and there is no guarantee of expected results. I also understand that several treatments may be necessary to complete the treatment. Electronic Aknowledgement Date Today (Month/Date/Year)
