OPAL FREE LED UV

INFORMED CONSENT, ASSUMPTION OF RISK & LIABILITY WAIVER

This informed Consent and Liability Waiver ("Agreement") is entered on the date signed below by the undersigned client ("Client") in connection with eyelash extensions services performed by the undersigned ("Technician").

Please read each section of this agreement carefully.

By placing checking the box below each section, you acknowledge you have read, understood, and agree to the statements contained in that section. Failure to initial a section does not invalidate the remaining provisions of this Agreement.

1. HEALTH DISCLOSURE & ELIGIBILITY

Client affirms that all medical history, allergies, sensitivities, medications, recent illnesses, and health conditions have been fully and accurately disclosed prior to receiving services.

Client understands that certain conditions may increase the likelihood of irritation or allergic response including but not limited to:

• Autoimmune disorders

• Compromised skin barrier

• Recent illness or infection

• Pregnancy or breastfeeding

• Use of immunosuppressive or acne medications

• Recent eye surgery or procedures

• Active eye conditions including blepharitis, conjunctivitis, styes, or infections

Client acknowledges that the Technician reserves the absolute right to refuse or discontinue service if, in the Technician's professional judgement, Client presents with contraindications or compromised health that may increase risk.

2. DESCRIPTION OF COSMETIC SERVICE

Client understands that this is a cosmetic procedure involving the attachment of synthetic eyelash extensions to natural lashes using the Opal Free™ LED UV adhesive system.

Client acknowledges and understands:

• Extensions are applied to natural lashes only.

• Adhesive is not applied directly to the skin.

• Extensions are placed approximately 0.5mm away from the eyelid skin to minimize contact with the periocular area.

• Temporary micro-pressure from isolation tools and lash placement is normal and inherent to the procedure.

• Aesthetic goals may be modified at the Technician’s discretion to preserve lash integrity and client safety

3. OPAL LED UV LAMP CONSENT

Client understands that the Opal Free™ adhesive will be cured using the Lash Apothecary Series 2 Lamp, which emits monochromatic 400nm light.

Client acknowledges:

• The Series 2 Lamp has been independently evaluated in accordance with IEC 62471 standards.

• The device is classified as Risk Group 0 (RG0) under normal conditions of use.

• The LED light is used externally while Client’s eyes remain fully closed.

• Exposure is brief, controlled, and solely for the purpose of adhesive polymerization.

• This device is not a tanning device or medical treatment.

Client voluntarily consents to the use of the Lash Apothecary Series 2 Lamp during service.

4. ADHESIVE DISCLOSURE & CHEMICAL ACKNOWLEDGMENT (OPAL FREE™)

Client understands that Opal Free™ is a proprietary adhesive system developed by Lash Apothecary and differs from conventional lash adhesives.

Client acknowledges:

• Opal Free™ does not contain cyanoacrylate or other acrylate-based adhesive chemistry.

• The curing process does not emit cyanoacrylate vapors or formaldehyde gases and primarily releases water vapor and trace oxygen during polymerization.

• Opal Free™ has undergone biocompatibility and risk management evaluation in accordance with ISO 10993 1 and ISO 14971 standards.

Client understands that:

• Opal Free™ is designed to reduce sensitization risk associated with traditional lash adhesives.

• No cosmetic product can guarantee the absence of irritation, inflammation, or allergic response. Individual immune responses are unpredictable

5. SERVICE REQUIREMENTS & CLIENT RESPONSIBILITY

Client agrees:

• To keep eyes fully closed throughout the procedure.

• To remain still during the service.

• That opening eyes prematurely may increase irritation risk.

• Client understands that the procedure may last several hours

6. ALLERGY, SENSITIVITY & PATCH TEST POLICY

Client understands:

• Allergic and sensitivity reactions may occur even without prior history.

• Reactions may be immediate or delayed, including 24–72 hours following application.

• Symptoms may include redness, swelling, itching, irritation, or contact dermatitis.

Client acknowledges that:

• Any client with a prior history of reaction to lash extensions must complete a patch test.

• A 72-hour monitoring period is mandatory prior to full application.

• A full set will not be performed without successful completion of the patch test when indicated.

• A prior reaction to conventional lash adhesives does not guarantee absence of reaction with Opal Free™.

7. ASSUMPTION OF RISK

Client acknowledges that all cosmetic procedures carry inherent risk. Possible adverse outcomes may include, but are not limited to:

• Redness

• Irritation

• Swelling

• Itching

• Contact dermatitis

• Delayed hypersensitivity reaction

• Discomfort requiring removal

Client understands that individual biological responses vary and no guarantee of a reaction-free experience can be made.

Client voluntarily assumes all known and unknown risks associated with this service

8. REMOVAL & MEDICAL CARE

Client understands that Opal Free™ is not an acrylate-based adhesive and requires a specific removal protocol.

Client agrees:

• Removal must only be performed by the Technician who applied the extensions or another Lash Apothecary–certified Opal Free™ professional.

• Self-removal is strictly prohibited.

• Removal by untrained providers may result in damage or injury.

Client agrees that any medical evaluation or treatment sought is at Client’s sole expense

9. AFTERCARE & MAINTENANCE

Client agrees to follow all aftercare instructions.

Client understands:

• Failure to follow aftercare may increase irritation risk.

• Improper aftercare may negatively affect retention and longevity.

• Natural lash shedding requires maintenance appointments to preserve appearance

10. NO GUARANTEE OF RESULTS

Client understands that:

• Cosmetic outcomes vary between individuals.

• Retention duration cannot be guaranteed.

• Absence of reaction cannot be guaranteed.

11. RELEASE, INDEMNIFICATION & HOLD HARMLESS

Client voluntarily releases, waives, discharges, and agrees to indemnify and hold harmless the Technician and their business from any and all claims, liabilities, damages, costs, or expenses, including reasonable attorney’s fees, arising from this procedure or any future services.

This Agreement remains in effect for future Opal Free™ services unless revoked in writing.

CLIENT ACKNOWLEDGMENT & SIGNATURE

By signing below, Client certifies:

• They are at least 18 years of age (or have documented parental/guardian consent).

• They have read this Agreement in its entirety.

• They understand its contents.

• They have had the opportunity to ask questions.

• They voluntarily agree to proceed.