About this template
This professional consent and intake form is designed for estheticians, lash artists, and brow technicians to streamline their pre-service workflow. It ensures that every client is fully informed about the chemical processes involved in lash lifts, brow laminations, and tinting, while clearly outlining potential risks and contraindications. By using this digital template, you protect your business by establishing a clear record of informed consent before any service begins.
Beyond simple consent, this form captures essential health data, such as contact lens usage and known sensitivities, which are critical for safe application. It also includes a dedicated section for aftercare acknowledgment, ensuring your clients understand how to maintain their results. Using Doc2Form to deploy this as a Google Form allows you to collect responses directly to your Google Drive, keeping your client records organized, accessible, and paperless.
Key features
- Comprehensive health and contraindication screening
- Clear sections for lash and brow service risks
- Digital aftercare acknowledgment for better results
- Easy-to-read layout for mobile-friendly client intake
- Seamless integration with Google Sheets for record keeping
Use cases
- New client onboarding for lash and brow studios
- Pre-appointment health screening for chemical treatments
- Digital waiver collection for salon liability protection
- Aftercare education and confirmation for permanent makeup services
What this form collects
- Client Full Name (Short answer)Please enter your legal first and last name.
- Contact Information (Short answer)Provide your best phone number and email address for appointment updates.
- Do you wear contact lenses? (Multiple choice)Please note that lenses must be removed prior to lash lift procedures.
- Lash Lift Contraindications (Paragraph)Do you have any current eye infections, styes, or recent eye surgeries?
- Brow Lamination Contraindications (Paragraph)Do you have any skin conditions, sunburns, or recent chemical peels in the brow area?
- Service Risk Acceptance (Multiple choice)I understand that while these services are safe, there is a small risk of allergic reaction or irritation.
- Aftercare Acknowledgment (Multiple choice)I agree to follow all aftercare instructions provided by my technician to ensure the longevity of my results.
- Signature (Short answer)Please type your full name here to serve as your electronic signature.
- Date of Signing (Date)Select today's date.
FAQ
Why is a consent form necessary for lash and brow services?
These treatments involve chemical solutions that can cause reactions in some individuals. A consent form ensures the client is aware of these risks and confirms they have disclosed any relevant health issues.
Can I add my own salon branding to this form?
Yes. Once you convert this template to a Google Form, you can use the Google Forms theme editor to add your logo, change colors, and match your brand's aesthetic.
How do I handle the signature requirement?
While Google Forms does not have a native 'draw' signature field, you can use a text field for the client to type their full name as a legal signature, or use a third-party add-on to capture a digital signature.
Should I use this for every appointment?
It is best practice to have clients sign a fresh consent form for each visit, or at least annually, to ensure their health history and contact information remain current.
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.