Eyelash Extension Consent Form

Eyelash Extension Consent Form

Please read and complete this consent form before receiving eyelash extension services.
Client Information
Full Name*
Please enter client's full name.
Date of Birth*

MonthDayYear
Please enter client's date of birth.
Phone Number*
Please enter a valid phone number.
Email Address*
Please enter valid email address.

Photo / Media Consent

Consent is optional and does not affect your service.
I consent to photos/videos being taken of my eyes/lashes during or after the procedure for documentation, training, or marketing purposes.*

Yes, I consent.No, I do not consent.

Consent & Agreements
Date of Service*

MonthDayYear
Acknowledgements*

I understand eyelash extensions require adhesive and individual application to my natural lashes.I acknowledge possible side effects such as irritation, redness, or temporary lash loss.I have disclosed all conditions, allergies, and relevant medical history to my technician. I understand failure to disclose may increase risk.I release and hold harmless Tammy Johnson, iBrow iLash Academy & Studio, its employees, contractors, and affiliates from any claims, damages, or actions arising from this service, except in cases of gross negligence or willful misconduct.I understand that payments made for lash services are non-refundable once services are rendered.
By signing below, I confirm that I have read and understood this consent form, all my questions were answered, and I voluntarily consent to the eyelash extension procedure at my own risk.*

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Client Information