Aura Consent Forms
Lash & Brow tinting
Personal / Contact Details
Name
Please enter Name.
Date of Birth (dd/mm/yyyy)
Please enter/select Date of Birth.
Email Address
Please enter Email Address.
Phone Number
Please enter Phone Number.
Postcode
Please enter Postcode.
Address
Please enter Address.
Therapist
Please enter Therapist.
Patch Test
All of our products undergo extensive testing in line with industry standards and comply with all applicable requirements to ensure that they are safe. However a person's reaction to any product is personal to them and products of any kind can cause allergy or other reactions.
We strongly recommend that all of our customers participate in a skin sensitivity test at least 48 hours prior to the full application of any product, to reduce the risk of an adverse reaction, even if previously used. However, you are responsible for your own safety and it is your decision as to whether you wish to participate in a test or not. Please tick the box applicable to you below, then sign and date this Consultation Form to confirm your understanding of this.
I have undergone an allergy/skin sensitivity test. I do, however, acknowledge that applying any product to the skin or hair is never entirely without risk.
Patch Test Date (dd/mm/yyyy)
Clear Signature
Have you ever used hair colour before?
Yes
No
Have you ever had an allergic reaction to hair colour?
Yes
No
Do you wear contact lenses?
Yes
No
Have you ever had your brows or lashes tinted?
Yes
No
Do you use any over-the-counter or prescription skin care products are you currently using?
Yes
No
Do you have diabetes, lupus, or any auto-immune disease?
Yes
No
If you had an adverse reaction to a previous tinting, please explain
Yes
No
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.
I understand that tinting lashes or brows has some risk of irritation to the orbital eye area, including the eye itself, and could result in stinging or burning, blurry vision should the tint enter into the eye.
I understand that if the tinting agent, developer, or mixture of both accidentally comes into contact with my eye, my eye will be flushed with water and medical attention may be required.
I understand that there may be some residual dark staining left on the skin following the tinting process of either my lashes, brows or both. This will fade and go away within a short time.
I understand that, while every attempt will be made to provide me with my chosen colour, everyone's hair absorbs colour differently and my final results may not be the colour I initially wanted.
I understand that over the course of several weeks, the tint will gradually lighten and fade. Re-tinting will be required to keep the new colour fresh. Most clients need to re-tint every 3-4 weeks.
Consent Form: Disclaimer
I understand a patch test is required before I have the above treatment due to a possible reaction to the product. However, I am prepared to take full responsibility with this disclaimer and will not pursue any action against the therapist or salon should there be any reaction what so ever. No refunds will be given.
Please accept Disclaimer.
Clear Signature
Submit Form