Clients consent forms

CLIENT INFORMATION FORM
Full Name*
Appointment*
Phone*
Email*
example@example.com
Instagram*
How did you hear about us?*
What products do you currently or have recently used on your eyelashes? (check all that apply)*

MascaraCurlerLash SerumLash Lift/TintNAOther
Do you wear glasses or contacts?*

Yes I wear glasses.Yes, I wear contacts.No
Have you had any type of eye surgery within the last 6 months?*

YesNoNA
Do you have frequent eye Irritation, itching, or watery eyes?*

YesNo
How do you sleep at night?*

BackStomachLeft SideRight Side
List any medications including supplements that you are currently using*
Do you have any of the following conditions? (check all that apply)*

Allergies to adhesive or syntheticsPregnancyDry eyesHypersensitivity to adhesive, tape, gelDiabetesEating disorderThyroid DiseaseExtreme stress or hormonal imbalanceNA
Do you have any allergies?*

YesNo
If yes, please list all allergies
EYELASH EXTENSION APPLICATION CONSENT FORM
Although every precaution will be taken to ensure your safety and well-being before, during and after your lash extension application, please be aware of the following information and possible risks. Read carefully and please sign:
I*
Input clients name
agree to have eyelash extensions applied to my natural eyelashes and/or removed and retouched. By signing this agreement, I consent to the placement and/or removal of the eyelash extensions by the certified eyelash extension professional. I understand that in rare occasions there are risks associated with having artificial eyelashes and eyelash extensions applied to or removed from my natural eyelashes. I further understand that in rare cases as part of the procedure eye irritation and discomfort could occur. I agree that if I experience any of these conditions with my lashes that I will contact the certified eyelash extension professional that performed this procedure and it may be beneficial to have the eyelashes removed. I understand and agree to the after-care instructions provided by the certified eyelash extension professional for the use and care of my eyelash extensions. I realize and accept the consequences of failure to adhere to these instructions may cause the eyelash extensions to fall out and/or decrease the time the lashes will last. I understand and consent to have my eyes closed and covered for the duration of approximately 30-180 minute procedure. Times may vary depending on the type and number of eyelashes applied.
I am informing the certified eyelash extension professional of the following conditions by marking with a check:*

Current use of contact lenses which I may be asked to remove during the procedureCurrent use of anything such as oil-containing sunscreen or moisturizers around the eyesCurrent use of eye drops of any kind, prescription or over-the-counterCurrent allergies or sensitivitiesHistory of an allergic reaction to eyelash extension productsHistory of recurrent eye or tear duct infectionsHistory of dry eyes or Sjorgen’s SyndromeRecent history of ChemotherapyOther medical conditions which would prohibit or compromise placement and retention of eyelashNA
Client Signature*

Clear
DATE*

MonthDayYear
Date
EYELASH EXTENSION APPLICATION CONSENT FORM
Full Name*
Is this your first time using lash extensions?*

YesNo
If no, why did you remove them?
I understand there are risks associated with having artificial eyelashes applied to and/or removed from natural eyelashes. I understand that the eyelash extensions will be applied to the natural lash as determined by the technician so as not to create excessive weight on the natural eyelash thereby preserving the health, growth, and natural look of my eyelashes. I understand as part of the procedure eye Irritation, eye pain, eye itching, discomfort, and in rare cases eye infection may occur. I understand and agree that if I experience any of these issues with my lashes that I will contact my technician and have the eyelashes removed immediately and consult a physician at my own expense. I understand that even though the technician may apply and remove the eyelashes properly, that adhesive materials may become dislodged during or after the procedure, which may irritate my eyes or require further follow-up care. I understand and agree to follow the after-care instructions provided by my technician. Failure to follow the after-care instructions can cause the eyelash extensions to fall out. I understand that in order to have the eyelash extensions applied to my eyelashes, I will need to keep my eyes closed for a duration of 2-4 hours during the procedure. I also understand that I will need to be lying in a reclined position. Any medical conditions that might be aggravated by lying still for a prologued period of time may mean I will not be able to have the procedure performed on my eyes. I understand that additional conditions could occur or be discovered during the procedure which could affect my ability to tolerate the procedure. I agree to have eyelash extensions applied to my natural eyelashes and/or removed and retouched. By signing this agreement, I consent to the placement and/or removal of the eyelash extensions by the certified eyelash extension professional.*

Clear
I agree to the following eyelash extension follow-up and maintenance instructions:*

No waterproof mascaraNo oil based products around the eye areaNo water can come in contact with the eye area for 4~5 hours after the applicationNo tinting or perming of eyelash extensionsNo pulling or rubbing of the eyelash extensionsNo use of pool, sauna or spa for 48 hours after
DATE*

MonthDayYear
Date
Parent/Guardian signature is required if the client is under the age of 18.
GUARDIAN NAME
Guardian Signature

Clear
DATE

MonthDayYear
Date
EYELASH EXTENSION SERVICE CONSENT FORM FOR COVID-19
Due to the 2019-2020 outbreak of the novel Coronavirus, COVID-19, we are taking extra precautions with the intake of each client, health history review, as well as sanitation and disinfecting practices. Please complete the following and sign below.
I*
(Client’s name) , confirm that I am not presenting any

of the following symptoms of COVID-19: fever, shortness of breath, loss of taste or smell, dry cough, runny nose, or sore throat.

I agree to the following: I understand the above symptoms and affirm that I, as well as household members, do not currently have, nor have experienced the symptoms listed above within the 14 days. I affirm that I, as well as household members, have not been diagnosed with COVID-19 within the last 30 days. I understand the COVID-19 virus has a long incubation period during which carriers of the virus may not show symptoms & still be highly contagious. I understand that due to the frequency of visits of other clients, the characteristics of the virus, and the characteristics of these services that I have an elevated risk of contracting the virus simply by being in the establishment. To prevent the spread of the contagious virus and to help protect each other, I understand that I must follow the establishment’s guidelines: Reschedule appointment if you are feeling unwell No additional guest is allowed Wearing a mask is required upon arrival and during the entire procedure Wash hands upon arrival Limit conversation during the procedure

I, knowingly and willingly consent to have eyelash extension service during the pandemic and will not hold (ENTER SALON NAME) or anyone working for this establishment, liable for the possibility of contacting COVID-19.
Client Signature*

Clear
DATE*

MonthDayYear
Date
Should be Empty:

CLIENT INFORMATION FORM

EYELASH EXTENSION APPLICATION CONSENT FORM

Although every precaution will be taken to ensure your safety and well-being before, during and after your lash extension application, please be aware of the following information and possible risks. Read carefully and please sign:

EYELASH EXTENSION APPLICATION CONSENT FORM

EYELASH EXTENSION SERVICE CONSENT FORM FOR COVID-19