About this template
A professional lash extension consent form is essential for every lash artist, esthetician, and salon owner. This template helps you collect vital client information before performing eyelash extension services, including contact details, known allergies, eye product sensitivities, and medical history. By screening clients beforehand, you protect your business and ensure the procedure is safe and appropriate for each individual.
Built with Doc2Form, this form streamlines your client onboarding workflow so you can spend less time pushing paper and more time perfecting your craft. Clients can easily review potential risks, aftercare guidelines, and policy details directly from their phone or computer before arriving for their appointment. The clean, structured layout guides them through each required question while ensuring you capture acknowledgment of your salon policies and emergency contact details.
Use this template as-is or customize the questions to fit your specific lash styling techniques, adhesive types, and pricing structures. It provides a seamless way to build trust, maintain organized client records, and establish clear communication from day one.
Key features
- Collect client contact and emergency details instantly
- Screen for eye sensitivities, contact lens use, and medical allergies
- Document client agreement to aftercare instructions and salon policies
- Mobile-friendly format for quick completion in the waiting area or at home
- Easily customizable questions to match your specific products and adhesive types
Use cases
- First-time eyelash extension appointments at a boutique salon
- Mobile lash artists onboarding new clients on location
- Annual client medical history and consent updates
- Esthetician schools and training student clinics
What this form collects
- Full Name (Short answer)Enter your first and last name as it appears on official documents.
- Phone Number (Short answer)We will use this to send appointment reminders and important updates.
- Email Address (Short answer)Where we can send your appointment confirmation and aftercare guide.
- Date of Birth (Date)Used for client verification and age confirmation if under 18.
- Medical History & Eye Conditions (Checkboxes)Select any conditions you currently have or have experienced in the past.
- Allergies and Sensitivities (Paragraph)List any known allergies to latex, adhesives, tape, bandaids, or cosmetics.
- Do you wear contact lenses? (Multiple choice)Please indicate if you wear contacts during the procedure.
- Previous Lash Extension Experience (Multiple choice)Have you ever had eyelash extensions applied before?
- Have you ever experienced an allergic reaction to lash adhesive? (Paragraph)Describe any redness, swelling, or irritation from past applications.
- Consent to Procedure (Multiple choice)By checking below, I acknowledge that I understand the risks, aftercare requirements, and potential side effects of eyelash extensions.
- Client Signature (Type Full Name) (Short answer)Typing your full name here serves as your legal electronic signature.
- Date Signed (Date)Today's date.
FAQ
Why is a lash extension consent form required?
It ensures clients are fully informed about the eyelash extension procedure, potential risks, and proper aftercare while confirming they do not have underlying sensitivities that could cause a reaction.
What medical details should be included in the form?
The form should screen for eye conditions, seasonal allergies, recent eye surgeries, contact lens usage, and sensitivities to cyanoacrylate or other adhesives.
How can clients fill out this form before their appointment?
You can send the Google Form link via email or text confirmation before their visit, allowing them to complete it conveniently from their mobile device.
Can I customize the questions on this template?
Yes! Once you generate the form in Google Forms, you can freely edit, add, or remove questions to match your exact salon policies and aftercare rules.
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.