Free Lash Extension Consent Form (Printable PDF)

A good lash consent form protects your client and your business before the first lash is placed. This free template covers eye health, adhesive allergies, aftercare and photo permission, and you can add your own logo and colours in seconds. Fill in the panel, download the PDF and print as many copies as you need.

Your Business Name

Lash Extension Consent Form

Please print clearly and tick all that apply.

Client details
Full name
Date of birth
Mobile number
Email address
How did you hear about us?
Lash history
Have you had lash extensions before?
YesNo
Any reaction to lash extensions in the past? If yes, please describe
Do you wear contact lenses?
YesNo
I have had (or choose to skip) an adhesive patch test and understand the risk of skipping it
Health check - tick any that apply
Eye infection, conjunctivitis or styes (current or recent)
Blepharitis, dry eye, glaucoma or other eye condition
Eye surgery or laser treatment in the last 6 months
Allergy to cyanoacrylate, latex, tape, adhesive or fragrance
Eczema, psoriasis or very sensitive skin around the eyes
Currently having chemotherapy or similar treatment
Pregnant or breastfeeding
Trichotillomania or lash pulling
Anything else we should know about your health, medication or allergies?
Consent and aftercare
I understand lash extensions carry a small risk of irritation, allergic reaction, redness or swelling, and I will tell my artist at once if I feel any discomfort
I have been given aftercare instructions: keep lashes dry for 24 hours, avoid oil-based products, never pick or pull, brush daily
I understand that lashes should be removed professionally and that fills need the right amount of existing extensions
Photo permission
I give permission for before and after photos of my lashes to be used on social media and in marketing
Booking policy
I have read and agree to the cancellation and late policy (24 hours notice; deposits non-refundable)
Signature
Client signature
Date

Created free with LuxeDesk · luxedeskapp.com

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What is a lash extension consent form?

A lash extension consent form is a signed record that your client told you the truth about her health, understood the risks of the treatment and agreed to your aftercare rules before you began. It is not a formality. Lash extensions put a medical-grade adhesive and synthetic fibres within millimetres of the eye, and a signed form is the clearest evidence that the conversation happened.

It also does a second job that many new artists miss: it is your intake screening. The ticked boxes tell you at a glance whether you need to patch test, adjust your adhesive, or politely decline the appointment.

What to include

Start with the basics you need to reach her and to confirm she is an adult: name, date of birth, phone and email. Then add the parts that are specific to lashes.

  • Lash history: previous extensions, past reactions, contact lenses.
  • Eye and skin health: infections, blepharitis, dry eye, recent eye surgery, eczema around the eyes.
  • Allergies, with cyanoacrylate, latex, tape and fragrance named so nobody has to guess.
  • Pregnancy, chemotherapy and lash-pulling habits, since these change how lashes grow and how skin reacts.
  • A patch test line, so a client who skips one has chosen to.
  • An aftercare acknowledgement, a photo permission tick box and your cancellation policy.
  • Signature and date.

Keep the language plain. A client who feels she is signing a legal contract will rush; one who is ticking an easy checklist will read.

When to use it

Use it at the first appointment, before any product touches the client, and ask her to sign on that day rather than ahead of time by email, because answers change. Many artists also ask for a fresh form once a year, and straight away if the client has been unwell, started new medication or become pregnant.

Fills and infills need a quick verbal check each visit ("anything changed since last time?"), but the signed form stays on file as your baseline. If a client returns after a long gap, treat her as new and start again with a clean sheet.

Tips from lash artists

Ask the health questions out loud as well as on paper. Clients often tick "no" quickly and then mention contact lens trouble or an old eye infection when you read the list back to her.

Put the aftercare in writing and hand over a copy. The most common reason for a bad outcome is a first-day mistake: a steamy shower, a face wash with oil, a rubbed eye. If she signed that she was told, your conversation about a redo becomes calmer for both of you.

Take the photo permission seriously. Some clients are happy for lashes to appear online but not their face, so a tick box that lets her choose is better than a blanket clause.

Store forms where you can find them. A pile in a drawer is no use when a client calls six months later with a question about her reaction.

Finally, record what you used. Writing the adhesive, lash type and curl on the client card means that if she reacts, you can narrow down the cause quickly and tell your supplier exactly what was on her lashes. It also makes her next set faster and more consistent, which clients notice and appreciate.

Common mistakes to avoid

  • Using one generic beauty form for every treatment. A form with no eye-health questions will not help you if a client develops an infection.
  • Letting a client sign without reading. If she signs in under ten seconds, ask whether she would like to go through it together.
  • Forgetting patch tests for sensitive or first-time clients. If she declines, note it on the form in writing.
  • Not asking about minors. If a client is under 18, check local rules and get a parent or guardian to sign.
  • Losing the paperwork. Digital copies are safer than paper in a drawer, and easier to search.

Frequently asked questions

Do I need a consent form for lash extensions?

In most places there is no single law that says you must, but insurers and training bodies strongly expect a signed form, and it is your best protection if a client has a reaction. Check what your insurer and local licensing board require.

How long should I keep lash consent forms?

Many professionals keep them for at least three to seven years after the last appointment, and for a minor until well after she turns 18. Rules differ by state and country, and your insurer may set its own limit, so ask them for the exact period.

Is a lash patch test required?

Not legally in most places, but it is good practice, especially for first-time and sensitive clients. If a client refuses one, write that on the form and have her sign it.

Can a client sign the form on her phone?

Yes. Electronic signatures are valid in many regions as long as you can show who signed and when. A signed PDF saved to the client profile is a tidy way to prove it.

Should I ask for a new form at every fill?

Not usually. Keep one signed form on file and ask a quick health check at each visit. Ask for a fresh form after a long gap, a medical change, pregnancy or an eye infection.

Does this template work for volume and hybrid lashes?

Yes. The health and aftercare questions are the same for classic, hybrid and volume sets. Add a line for set type if you want to record it.

This template is for general information only and is not legal advice. Check the requirements in your state or country.