Eyelash Extension Consent Form ✨💖
Please read the terms carefully and provide your consent to proceed with the eyelash extension service.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Do you have any allergies to adhesives, latex, or cosmetics?
*
Yes
No
Are you currently experiencing any eye conditions (such as conjunctivitis, styes, or recent eye surgery)?
*
Yes
No
Please list any medical conditions or medications that may affect this procedure.
Do you have oily or dry skin?
Oily
Dry
Do you like long or short sets ?
Short 9-13mm
Medium 10-14mm
Long 11-17mm
Client Signature
*
Date
*
-
Month
-
Day
Year
Date
Submit Consent
Submit Consent
Should be Empty: