Lash Extension Consent Form Template

Important Client Agreement

This document is provided as a standard client authorization and acknowledgment form for eyelash extension services. It is intended solely for informational purposes and does not replace personalized consultation with a licensed beauty professional. Clients are advised to read all content carefully, understand the risks involved, and communicate any concerns or allergies prior to treatment. Usage of this form is at the client’s own discretion, and the provider assumes no liability for adverse reactions or outcomes arising from the procedure. Variations in regulations and best practices may apply depending on local licensing requirements. Please ensure all necessary details are accurately completed and understood before proceeding.

This is a sample Lash Extension Consent Form. Please customize the details to suit your specific procedures and client information.

Lash Extension Consent Form – Sample Template

Parties Involved:

Service Provider: Elegant Lash Studio
Address: 789 Beauty Lane, Glam City, CA 90210

Client: [Client Name]
Address: [Client Address]

Description of the Service:

Application of semi-permanent eyelash extensions intended to enhance the length, curl, fullness, and thickness of natural eyelashes, performed by certified technician.

Consent and Acknowledgment:

I, the undersigned client, understand that eyelash extension application is a cosmetic procedure that involves adhesive, tools, and techniques that may carry risks. I acknowledge that I have been informed of potential risks, aftercare requirements, and possible side effects, including allergic reactions or discomfort.

Client Information:

Name: [Client Name]
Date of Birth: [DOB]
Contact Information: [Phone/Email]

Risks and Aftercare:

The client agrees to follow all aftercare instructions provided and understands that improper care may result in damage to natural lashes or other adverse effects. The service provider is not responsible for any issues arising from non-compliance with aftercare guidelines.

Additional Provisions:

• Any allergies or sensitivities must be disclosed prior to the procedure.
• The client affirms they are not currently pregnant or nursing unless approved by the technician.
• The client understands that the longevity of eyelash extensions varies based on individual eyelash health and aftercare.
• Follow-up appointments or touch-ups are recommended within the specified time frame.

Location: Glam City, CA
Date: ______________________