Eyelash Extension Consent Form 2026

Eyelash Extension Consent Form 2026

We appreciate your choice of Bella Bree Lashes and eagerly anticipate meeting your beauty needs!
Name*

First NameLast Name
Phone Number*
Format: (000) 000-0000.
Email*
example@example.com
TikTokInstagramFacebookFriendOther
YesNo
YesNo
If yes, did you experience any issues with the lash extensions and when was the last time you had them applied?
Permanent makeup in the last 2 weeksLash Lift in the last 6-8 weeksBotox or filler in the last 2 weeksLash extensions removed in the last 4 weeksLash tint in the last 48 hoursNone of the above
**Your health history will remain confidential and will only be accessible to you and the lash extension artist. These questions are crucial for determining your eligibility for lash extensions and whether you require any additional accommodations.
Allergy to adhesives band aid or medical tapeAllergy to surgical glue or nail glueSeasonal allergiesBlepharitis (inflamed eyelids)Sensitive eyesDrugs that can cause temporary hair lossUse of contact lensesDry EyeTrichotillomania (hair pulling disorder- eyelashes, brows, hair from scalp)Hormonal imbalance/Thyroid diseaseIron deficiency/Nutritional deficienciesChemotherapy or radiation therapyPregnantMenopauseAlopeciaChronic inflammatory disease (psoriasis, rheumatoid arthritis, lupus, scleroderma)EpilepsyAnxiety, difficulty laying down with your eyes closed for long periods of timeNone of the aboveOther
I hereby agree to have eyelash extensions applied to my natural lashes and consent to the placement and/or removal of the eyelash extensions by the certified professional.I understand and agree to the after-care instructions and for any unexpected circumstance that have happened due to not following these instructions are in my own risk.I understand that in rare occasions there are risks associated with having artificial eyelashes. I further understand that in rare circumstances eye or skin irritation and discomfort may occur.I understand that because of my natural lash cycle, I will need to maintain my extensions with fill appointments recommended every 2 to 3 weeks to keep them full and to keep natural lashes healthy.I consent to having my lash artist utilize a LED UV light curing system near my eyes. The system used is FDA-approved and provided by Lash Apothecary. All liquids used are produced in the United States in an FDA-approved facility. This system is considered safe for use in the eye area.I acknowledge that in the event of an allergic reaction, I will reach out to my lash professional right away. I also understand that there are no refunds available if I experience a reaction after my eyelash extensions have been applied.I understand and consent to having my eyes closed and covered for the duration of approximately 60-180 minutes. Times may vary depending on the service provided and quantity of eyelashes.No guests, no children, and no pets are allowed inside of the studio unless asked first for permission by your service provider.I agree to the cancellation and late policy that is listed on the booking website under about me. It is also listed and checked off that you agree to it before you proceed with booking your appointment. As well as listed down below in this consent form. So please take the time to read it.
CANCELLATION/RESCHEDULING AND LATE POLICY

Lash & Brow Appointment Policy

To provide the best experience for all clients, please provide a minimum of 48 hours’ notice for any cancellations or rescheduling.
• 48–24 hours’ notice: 50% of the scheduled service will be charged.
• Less than 24 hours’ notice or no-show: 100% of the scheduled service will be charged.

If a deposit was paid and proper notice is not given, it will become non-refundable and non-transferable.
If no deposit was paid, the card on file will be charged according to this policy.

All Full Lash Extension Sets require a non-refundable deposit, which may be transferred once to reschedule the same appointment. Any additional rescheduling will require a new deposit.

Your understanding and respect for these policies allow for a smooth and accommodating schedule for all clients. Thank you for valuing my time and artistry. 🤍

Failure to provide a cancellation fee will lead to termination, and the individual will not be permitted to return for services.

Please note that there is a 10-15 minute grace period; if the delay exceeds 20 minutes, the appointment will be canceled and charged 100%. This is to ensure there is adequate time to prepare and provide the full service, without disrupting the schedules of other clients.
I hereby give permission to Bella Bree Lashes to utilize photography. I consent to the taking, publication, and reproduction of images featuring my face, eyes, or eyelashes, both before and after this service, for advertising, educational, or any other purposes. This includes the right to enhance these photographs as the eyelash extension artist sees fit. Additionally, I assign any copyright associated with these photographs to the eyelash extension artist.*

Yes, eyes and faceYes, just eyes and no faceNo permission
Date*

MonthDayYear
Date
Client Signature*

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Technician Name

First NameLast Name
**All terms and conditions need to be checked off to move forward with your lash service. If you have any questions or concerns please reach out to discuss this before your lash appointment.
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