About this template
Running a lash studio requires meticulous record-keeping and clear liability protection. This Eyelash Extensions Consent Google Form Template streamlines client intake by gathering critical health history, eye condition disclosures, and required policy acknowledgments before any service begins. Designed specifically for lash artists and beauty salon owners, the form addresses crucial risk factors such as recent eye surgeries, contact lens use, allergies, thyroid medications, and skin sensitivities.
Beyond health screening, the template covers essential studio policies including refill terms, no-refund rules, adverse reaction care, and photo release permissions. Clients can easily complete the entire questionnaire on their smartphone or computer before arriving for their appointment, saving valuable time in the salon.
With Doc2Form, you can instantly turn this template into your own custom Google Form, ready to send to clients via email or text. Keep your records organized in a connected spreadsheet, ensure full transparency around aftercare requirements, and protect your business with clear signed acknowledgments.
Key features
- Collect comprehensive client health and eye history securely
- Document mandatory initials for studio policies and refund terms
- Screen for contraindications like Lasik surgery or adhesive allergies
- Include photo release and liability waiver sign-offs
- Access responses instantly in an organized Google Sheet
Use cases
- New client onboarding at boutique lash salons and home studios
- Pre-appointment screening for full sets and regular fill appointments
- Documenting medical disclosures and allergy acknowledgments
- Securing signed photo releases for social media portfolios
What this form collects
- Full Name (Short answer)Enter your first and last name.
- Date of Birth (Date)Format: MM/DD/YYYY
- Cell Phone Number (Short answer)Best number to reach you for appointment confirmations.
- Email Address (Short answer)Where we can send your appointment confirmation and aftercare guides.
- Are you currently under the influence of any drugs or alcohol? (Multiple choice)Services cannot be performed if under the influence.
- Is this your first time getting eyelash extensions? (Multiple choice)Let us know if you are new to extensions.
- What is your main purpose for getting lash extensions? (Short answer)E.g., everyday wear, special event, vacation.
- Do you wear contact lenses? (Multiple choice)Select your current contact lens usage.
- Are you wearing eye makeup today? (Multiple choice)Lashes must be clean and free of makeup prior to application.
- Do you frequently rub, pull, or touch your eyes/lashes? (Multiple choice)Habitual touching can affect retention.
- Do you have any current eye illnesses, infections, or injuries? (Multiple choice)E.g., conjunctivitis, styes, severe dryness.
- List any current eye drops or medications you are using (Paragraph)Include prescription and over-the-counter eye drops.
- Are you able to comfortably lie flat on your back for 2 hours? (Multiple choice)Required during the application process.
- Are you able to keep your eyes completely closed for the duration of the service? (Multiple choice)Crucial for safety and avoiding adhesive fumes.
- Are you pregnant or nursing? (Multiple choice)Hormonal changes can occasionally affect lash retention.
- Medical History Disclosures (Checkboxes)Please indicate if you have experienced any of the following:
- What is your typical sleeping position? (Multiple choice)Side or stomach sleepers may experience faster lash shedding on one side.
- Do you use lash growth serums (e.g., Latisse, GrandeLash)? (Multiple choice)Growth serums can alter natural lash growth cycles.
- Oil-Based Product Notice Initials (Short answer)Type your initials to confirm you understand that oil-based skincare products break down lash adhesive.
- Mascara & Eyeliner Guidance Initials (Short answer)Type your initials confirming you will avoid waterproof mascara and eyeliner on lash extensions.
- Maintenance & Refill Terms Initials (Short answer)Type your initials acknowledging that fills are recommended every 2–3 weeks and require at least 40% retention.
- No-Refund Policy Initials (Short answer)Type your initials confirming our policy that service fees are non-refundable.
- Adverse Reaction & Allergy Risk Acknowledgement Initials (Short answer)Type your initials acknowledging that rare allergic reactions, redness, or irritation can occur and proper aftercare must be followed.
- Photo Release Status (Multiple choice)Do you grant permission for photos of your lash extensions to be used for promotional and portfolio purposes?
- Liability Release Initials (Short answer)Type your initials to release the technician and salon from liability for any allergic reactions or unintended outcomes resulting from undisclosed health conditions.
- Terms Acceptance Signature (Short answer)Type your full legal name to certify that all information provided is accurate and you accept all terms.
- Signing Date (Date)Today's date.
FAQ
How do I send this consent form to my clients?
Once you convert this template using Doc2Form, you can share the Google Form link via text message, email, or post it on your booking page so clients fill it out before arrival.
Can I customize the questions or add my salon's specific policies?
Yes! Because the template lives in your Google Drive as a standard Google Form, you can fully edit, add, or remove any questions, sections, or policy terms to fit your business.
Why is a health history disclosure necessary for eyelash extensions?
Certain conditions—such as recent eye surgery, chemotherapy, thyroid medication, or severe allergies—can impact adhesive retention or increase the risk of adverse reactions.
How does Doc2Form help me set up this form?
Doc2Form instantly builds this exact template directly into your Google account with zero manual setup required, allowing you to start collecting client submissions immediately.
Get this form in your Google Drive
Save a copy to your Google Drive with one click (uses 1 credit). Or build from a PDF or description in the app.