Form templates / Beauty & Salons
Lash Extension Consent Form
A lash extension consent form is about one thing above all: the adhesive. Cyanoacrylate reactions are the risk that ends appointments early, and the questions that predict them are easy to ask and easy to skip.
For salons, stylists, nail techs and independent beauty professionals.
Adhesive sensitivity, and eyes that were already unhappy
A reaction to lash adhesive can close an eye. It's rare, it's usually predictable, and the predictors are all questions: previous reactions, hay fever season, recent eye surgery, contact lens irritation, an existing infection.
Asked on a form the day before, you get answers with time to act - a patch test, a different adhesive, or a polite postponement. Asked while a client is lying down with their eyes taped, you get a shrug.
Say what they're agreeing to, in plain words
A consent form that nobody reads protects nobody. The statements in this template are short, specific and separate - so ticking one is a real decision rather than a formality.
Edit the wording to match what you actually do. It should sound like your practice, not like a legal template.
Patch tests, allergies and colour history
The questions that protect a colour appointment - previous dye, home kits, allergies, patch test dates - are exactly the ones that get skipped when a booking happens in a DM. Asked on a form, they're answered honestly and in writing.
It also protects the diary. Knowing the current colour and the goal before the appointment is the difference between a two-hour slot and a five-hour rescue.
Digital, dated, and searchable
Every response is stored with the date and time it was submitted, and the whole set exports as a spreadsheet. Finding one person's answers takes seconds rather than a filing cabinet.
Yours to change, immediately
Nothing here is fixed. Rewrite a question, reorder them by dragging, add your brand colour, delete half of it. Save and the live form updates - there's no separate publish step and no deploy to wait for.
What this template asks
- Full name
- Email address
- Phone number
- Date of birth
- Which service?
- Have you ever reacted to lash adhesive or glue?
- What happened, and when?
- Do any of these apply?
- Patch test
- Any medication or eye drops?
- Are you pregnant or breastfeeding?
- I understand irritation, redness and allergic reaction are possible, and that reactions can occur even after previous treatments
- I will avoid water, steam and oil-based products for 24 hours and follow the aftercare given
- I will not attempt to remove the extensions myself
- The information above is accurate
More Beauty & Salons forms
Questions
How do I handle clients who've reacted before?
Take it seriously: ask what happened and when, and treat a previous reaction as a reason to patch test with your current adhesive - or to decline. The form gives you that in writing before they arrive.
Should infills use the same form?
Most studios send it once and re-send it annually, with a shorter check at each infill. Duplicate the template and cut it down for the infill version.
Is this legal advice?
No. The wording is a practical starting point, not a legal document - have your own adviser check anything you rely on, especially where health, minors or money are involved.
Is a tick box a valid signature?
In many places a clear, dated, affirmative action is accepted, but it depends on your jurisdiction and what you're doing. If you need a drawn signature, print the response and sign it, or take the form as the pre-appointment record.
Can I keep a copy for the person who filled it in?
Yes - they see a confirmation on screen, and you can turn on an email so a copy of each submission lands in your inbox for your records.
Can I use this for patch test records?
Yes, and many salons do: the response is stored with the date it was submitted, which is the record you want if a reaction is ever disputed. Have your insurer confirm what they expect you to keep.
Publish your lash extension consent form today
Start from this template and change anything you like. Free to begin.