Eyelash Extension Consent Form

Personal Information

Full Name Date of Birth Phone Number Email Address

Medical History

Do you have any of the following? (Check all that apply) List any medications you are currently taking:

Consent

I understand that eyelash extension services involve attaching synthetic lashes to my natural eyelashes. I acknowledge the potential risks such as irritation, allergic reaction, or damage to my natural lashes. I agree to follow aftercare instructions provided by the technician. I certify that the above information is true and correct.

Client Signature Date