Lash extension consent formfree template to copy
Lash extensions put an adhesive a few millimeters from the eye, for up to three hours. The consent explains that in plain words: what happens, how the eye can react, when you won’t treat, and what the client must do afterwards.
Lash service consent
The same wording clients sign in Luvira. Copy it and adapt it to your services and your state.
Lash service consent
Lash extensions are applied one by one to your natural lashes with a professional adhesive. Depending on the style, the appointment takes one to three hours with your eyes closed.
Possible reactions: eye irritation or redness, watery eyes and, in rare cases, an allergic reaction to the adhesive (cyanoacrylate) that can include swelling of the eyelid. If you have known sensitivities, we do a patch test first.
We do not treat during an active eye infection (such as pink eye or a stye), eyelid inflammation, or soon after eye surgery.
Aftercare: no water, steam or sauna for 24 hours. Do not pick or rub, and avoid oil-based products around the eyes. How long extensions last depends on your natural lash cycle; a fill every two to three weeks is typical.
Please contact us if anything feels unusual after your treatment — strong pain, lasting redness, swelling or signs of infection. The sooner we know, the easier it is to help.
We cannot guarantee a specific result: skin, hair and healing differ from person to person. We work to the best of our professional knowledge and have explained the procedure, risks and alternatives to you. You had the opportunity to ask questions, and your questions were answered.
Questions to add to your intake form
Have you had lash extensions before, and did you react to the adhesive?
Do you have allergies to cyanoacrylate, latex or medical tape?
Do you wear contact lenses, and will you remove them for the appointment?
Have you had eye surgery, including LASIK, in the last months?
Do you currently have an eye infection, stye or eyelid inflammation?
Do you use lash growth serums or prescription eye drops?
What a lash consent has to cover
Adhesive is the center of every lash consent. The fumes can make eyes water, and a small number of clients develop an allergy to cyanoacrylate that can swell the eyelid. The form should say that clearly, offer a patch test for sensitive clients and name the eye conditions you will not work on.
Aftercare belongs in the consent too. Water, steam and oil-based products in the first day weaken the bond, and picking at extensions damages natural lashes. When it is written and signed, a client who ignored it cannot blame the application.
Ask about contact lenses and surgery
Two intake questions are specific to lash work: contact lenses, because clients keep their eyes closed for a long time, and recent eye surgery, because the area must be fully healed. Put them on the questionnaire so you know before the client lies down.
Template, not legal advice. Consent requirements differ by state and by service — check your state board’s rules and have the wording reviewed before you use it.
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Frequently asked questions
About consent forms for lash extensions
Requirements depend on your state board, but a signed consent is standard practice for lash extensions. It documents that the client knew about adhesive reactions and aftercare before the service.
Many lash artists patch test new clients and anyone with known sensitivities. The template says you will test when a sensitivity is known.
Not today. In Luvira the consent wording is fixed and stored with a version number on every signature. You can copy and adapt the template here for paper or your own system.
Luvira keeps signed forms for three years. Check whether your state or insurer expects a different period.
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