What should a lash extension consent form include?

Contact details, the service, previous lash treatments, contact lens use, allergies (especially to adhesives and latex), recent eye surgery or infection, and a signed agreement covering the risks and the aftercare.

Do I need a consent form for lash extensions?

Requirements vary by state and insurer, so check yours. Most lash artists use one because it documents that the client disclosed their history and accepted the aftercare.

Can I use this form for lash lifts?

Yes. Tick lash lift as the service; the allergy and eye questions apply to lifts too. For microblading or permanent makeup, add questions about blood thinners and skin healing.

Free template · Printable

Lash extension consent form template

A lash extension consent and intake form for lash artists, covering full sets, fills and lash lifts. It records allergies, eye conditions and contact lens use, and the client's agreement to the aftercare.

Lash extension consent form

Contact details

Full name

Phone

Date of birth

Address

Your appointment

Service

Full setFillLash liftRemoval

Have you had lash extensions or a lift before?

YesNo

Do you wear contact lenses?

YesNo

Before we start

Do any of these apply?

Allergy to adhesives or latexRecent eye surgery (last 3 months)Eye infection or irritationSensitive or watery eyesPregnancy

Please describe anything ticked above

Consent

I understand that lash extensions are applied with an adhesive and that some people react to it, even after previous treatments without a reaction. I will tell my lash artist straight away if I feel stinging or discomfort.

I agree to follow the aftercare instructions I have been given, and I understand that extensions shed with my natural lash cycle.

Signature

Date

Your business name

Sections

Contact detailsYour appointmentBefore we start

Choose “Save as PDF” in the print dialog to download. Nothing you type leaves your browser.

Use it on your website

Put the short version online. AI calls them back in 60 seconds.

Long forms on a phone get abandoned. With RingOwl, your website asks three questions. If the visitor ticks “call me back”, your AI calls within a minute, asks the rest of this form, books the appointment and saves a complete record, with their consent on file.

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Test the callback in your browser during the trial. Phone callbacks need a paid plan (US, Canada, UK, Australia and India numbers).

On your website

Full name
Phone
Which service (full set, fill, lift, removal)?
“Call me back within a minute” box

Asked on the AI callback

First time having lash extensions or a lift?
Allergies to adhesives, latex or cosmetics
Recent eye surgery, infection or sensitivity
Do you wear contact lenses?
Preferred day and time

How to get the most out of a lash extension consent form

Ask about adhesive and latex allergies first: It's the question most likely to change the treatment, so it shouldn't be the last line on the form.
Remind clients to arrive without lenses and makeup: Mention it when you confirm the booking, not when they're already in the chair.
Keep the signed form on file: This template is a starting point, not legal advice. Check it against your state's rules and your insurer's requirements.

Lash extension consent form FAQ

What should a lash extension consent form include?+
Contact details, the service, previous lash treatments, contact lens use, allergies (especially to adhesives and latex), recent eye surgery or infection, and a signed agreement covering the risks and the aftercare.
Do I need a consent form for lash extensions?+
Requirements vary by state and insurer, so check yours. Most lash artists use one because it documents that the client disclosed their history and accepted the aftercare.
Can I use this form for lash lifts?+
Yes. Tick lash lift as the service; the allergy and eye questions apply to lifts too. For microblading or permanent makeup, add questions about blood thinners and skin healing.
Is this template legally binding?+
It's a starting point, not legal advice. Have it reviewed for your state and services.

The consent wording on this template is a starting point, not legal advice. Have it reviewed for your state, your licensing board and your insurer.

More free intake form templates