Eyelash Extension Consent Form Template

An eyelash extension consent form is an intake and consent document completed before an eyelash extension service. It collects the client's health history, screens for contraindications, and documents the client's understanding and acceptance of the risks associated with the service.

Adhesive reactions, eye irritation, and lash damage are real risks — especially for clients with sensitivities or conditions that weren't disclosed. A consent form protects both the client and the technician by ensuring relevant health information is collected before every service.

A complete lash extension consent form covers health history and service expectations. Consider including:

• Client's full name and date of birth
• Known allergies to adhesives, latex, or fragrances
• Current or recent eye conditions (dry eye, conjunctivitis, styes)
• Contact lens use and removal prior to service
• Previous lash extension experience and any prior reactions
• Confirmation of service expectations and aftercare responsibilities

Include aftercare and reaction guidance in the form or confirmation message. Advise clients to contact the salon immediately if they experience persistent redness, swelling, or discomfort after 24 hours, and to seek medical attention if symptoms are severe. Document the incident on file regardless of whether a formal complaint is made.

Yes, at least periodically. A client's health status can change — they may have developed new sensitivities, started new medications, or had eye procedures since their last visit. Review and update consent forms at least annually for regular clients, and always re-screen if there's been a significant gap between appointments.