• CLIENT INFORMATION FORM

  • Appointment*
  • Format: (000) 000-0000.
  • What products do you currently or have recently used on your eyelashes? (check all that apply)*
  • Do you wear glasses or contacts?*
  • Have you had any type of eye surgery within the last 6 months?*
  • Do you have frequent eye Irritation, itching, or watery eyes?*
  • How do you sleep at night?*
  • Do you have any of the following conditions? (check all that apply)*
  • Do you have any 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:

  • 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:*
  • DATE*
     / /
    2 digit month, 2 digit day, 4 digit year

  • EYELASH EXTENSION APPLICATION CONSENT FORM

  • Is this your first time using lash extensions?*
  • I agree to the following eyelash extension follow-up and maintenance instructions:*
  • DATE*
     / /
    2 digit month, 2 digit day, 4 digit year

  • Parent/Guardian signature is required if the client is under the age of 18.

  • DATE
     / /
    2 digit month, 2 digit day, 4 digit year

  • 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.

  • (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.

  • DATE*
     / /
    2 digit month, 2 digit day, 4 digit year
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