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Risks & Patch test

Although none of my clients ever had any serious adverse reactions from the products and solutions use at “The salon Lepetie”, I must inform you that there is always a possibility one may occur. Please feel free to ask any questions or concerns you may have.


Please read carefully and only check the box on the health waiver form if you fully agree with this contents and choose to avoid receiving a patch test prior to the service.


  • I am aware and understand that receiving any chemical service can result in an allergic reaction.

  • I understand that a reaction can occur at any time even if I have received this service on previous occasions.

  • It has been explained to me what to expect with the chemical service I am about to receive, and I am willing to proceed.

  • I understand that I may ask to receive a skin patch test twenty-four to forty-eight hours in advance prior to all chemical services.

  • I understand that a negative patch test does not mean that a reaction will not still occur.

  • I understand these risks and if I have any concerns, I will seek medical advice prior to any chemical service.

  • I understand that it is extremely important to inform my stylist of all other processes I have used or have had done on my eyelashes and eyebrows in the last six months to assist in order to achieve my desired results.

  • I understand that I must inform my stylist of any allergies that I may have. I understand that this is very important information and that any information I withhold regarding my previous processes will increase my chances of unpredictable chemical reactions or undesirable results.

  • I understand and acknowledge that I and my stylist have had a consultation prior to proceeding and I was given very transparent and realistic expectations on the results I will have followed my chemical and or color service.

  • If there are any product or after care recommendations given to me to improve the health of my eyelashes and eyebrows or to maintain the results after the service, I acknowledge that I am to follow the directions and or advice. If I do not follow these recommendations, I am not to hold “The salon Lepetie” responsible for underachieved results. I also understand that results may vary per individual depending on hair type, texture, porosity, etc.


Further, I grant Yuki / “The salon Lepetie”, a permission to perform any chemical services. I do not hold her/them responsible for all adverse health reactions from this service, or for any undesired results based on the information in this waiver and per our discussion of what results are to be expected. This shall be binding upon me, my heirs as well as any legal representatives.

I acknowledge this consent will cover the entire service as well as subsequent chemical services I may have at “The salon Lepetie”. I also acknowledge if any of my eyelashes and eyebrows, medical or health history changes that may affect my services, I am to inform and update the salon to make sure I will continue to receive desired results.

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