Form

Name

First NameLast Name

Email

example@example.com

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

How did you hear about me?

Do you perm or tint your eyelashes?

Have you ever had eyelash extension applied?

Do you wear glasses?

Do you wear contacts? If yes, please remove them before your appointment.

Have you undergone any recent eye surgery?

If yes, when?

Please list any medication you are using:

Do you have any allergies?

Do you have any intolerance to chemicals, a hypersensitivity to odors?

If yes, please specify:

Please check all that may apply to you:

I have dogs in my home. They will remain in a separate room during your lash appointment. Are you comfortable with this?

Would you be comfortable with photos/videos being taken during your appointment and used for my business content?

I understand that eyelash extensions are a cosmetic service involving the application and removal of extensions to my natural eyelashes using professional adhesive products. I understand that, as with any cosmetic service, there are potential risks and side effects.

I understand that possible reactions may include, but are not limited to, temporary redness, watering, irritation, itching, discomfort, sensitivity, swelling, allergic reaction, or infection. I understand that reactions can occur during or after the appointment, even when the service is performed properly.

I understand that my eyelash extensions will be selected and applied based on the condition, length, thickness, and strength of my natural eyelashes. I understand that extensions that are too heavy or long for my natural lashes may cause unnecessary stress or damage, and I authorize my technician to adjust the length, thickness, or style when necessary to protect the health of my natural lashes.

I understand that I must keep my eyes completely closed throughout the application process and remain in the required position for the duration of my appointment, which may be approximately 120–240 minutes, depending on the service.

I understand that I am expected to remain comfortably reclined on my back for the duration of my appointment. I understand that She Is Studio may be unable to perform the service if I am unable to maintain the required position for the duration of the appointment. I understand that I am responsible for informing my technician before booking if I have any condition, including pregnancy, that may prevent me from comfortably maintaining this position. If I become uncomfortable or unable to maintain the required position during the appointment, my technician may pause or discontinue the service.

I understand that certain medical conditions, physical limitations, or circumstances that make prolonged reclining or lying still uncomfortable may prevent me from safely or comfortably receiving the service.

I confirm that I have provided accurate and complete information on my consultation and consent form, including any relevant allergies, sensitivities, eye conditions, previous reactions, medications, pregnancy, or other circumstances that may affect my appointment. I understand that withholding relevant information may increase the risk of an adverse reaction or complication.

I understand that lash retention varies from person to person and that no specific retention period can be guaranteed. Factors such as natural lash growth, oil production, lifestyle, skincare products, medications, environmental conditions, and individual lash characteristics may affect retention.

I agree to follow all aftercare instructions provided by She Is Studio. I understand that failure to follow proper aftercare may result in poor retention, premature shedding, irritation, or damage to my natural lashes.

If I experience significant irritation, swelling, pain, redness, or another concerning reaction, I agree to contact She Is Studio as soon as possible. I understand that I may be advised to have the extensions professionally removed and/or seek medical attention. I understand that any medical evaluation or treatment is my responsibility and should be obtained from an appropriate healthcare professional.

I understand that I should not attempt to remove my extensions myself and that improper removal may damage my natural eyelashes or cause injury.

I understand and agree that my appointment may be stopped or declined if my technician determines that continuing the service may be unsafe, unsuitable, or may compromise the health of my natural lashes or eyes.

I understand that lash extensions are a cosmetic service and that results, appearance, and retention may vary based on my individual natural lashes and other factors. I understand that there is no guarantee of a particular result or retention period.

I acknowledge that I have read and agree to the She Is Studio booking policies, including policies regarding deposits, cancellations, rescheduling, late arrivals, no-shows, fill eligibility, foreign fills, and payment methods.

By selecting my preferred option below, I give She Is Studio permission to use approved photos and/or videos taken during my appointment for business and promotional purposes, including Instagram, other social media platforms, Google Business Profile, the She Is Studio website, and online booking pages.

I understand that I may choose whether or not my face is included. Selecting “Yes, lash photos + face photos” gives permission for my face to be included. Selecting an option that does not include face photos means my face will not be intentionally included in promotional content.

By signing this form and selecting “Yes,” I confirm that I have read and understood this consent form, had the opportunity to ask questions before receiving the service, provided accurate information about anything that may affect my appointment, understand the potential risks and responsibilities explained above, agree to follow the aftercare instructions provided by She Is Studio, understand and agree to the booking policies of She Is Studio, and voluntarily consent to receiving eyelash extension services from She Is Studio.

Client Signature

Form

Consultation and Consent Form