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Eyelash Consultation and Consent Form

Customer Details


Eyelash extensions require medical tape and adhesives that may contain acrylic or latex.


I agree to have eyelash extensions applied to my natural eyelashes and/or removed and retouched.
By signing this agreement I consent to the placement and/or removal of the eyelash extensions by the certified eyelash extension professional.
I understand that in rare occasions there are risks associated with having artificial eyelashes and eyelash extensions applied to or removed from my natural eyelashes.
I further understand that in rare cases as part of the procedure eye irritation and discomfort could occur.
I agree that if I experience any of these conditions with my lashes that I will contact the certified eyelash extension professional that performed this procedure and it may be beneficial to have the eyelashes removed.
I understand and agree to the after-care instructions provided by the certified eyelash extension professional for the use and care of my eyelash extensions. I realize and accept the consequences of failure to adhere to these instructions may cause the eyelash extensions to fall out and/or decrease the time the lashes will last.
I understand and consent to having my eyes closed and covered for the duration of approximately 60-120 minute procedure. Times may vary depending on the type and number of eyelashes applied.

I am informing the certified eyelash extension professional of the following conditions by marking with a check.

Tap or click on the signature above to sign

Follow-up and Maintenance Instructions

No waterproof mascara.
No oil based products around the eye area.
No water can come in contact with the eye area for 24 hours after the application.
No tinting or perming of eyelash extensions.
No pulling or rubbing of the eyelash extensions.
Should any kind of eye drops be necessary extra care should be taken to prevent moisture from coming into contact with the eyelash extensions.

Data Protection and Privacy

We are committed to protecting your privacy. We take special precautions with your sensitive personal data and we will process your data lawfully and as described. We only process the data we need for as long as we need to and we respect all of your rights under GDPR. We will never sell, share or otherwise abuse your data. You can contact us at anytime to request your data, change your preferences or request that your data be deleted. GDPR is the European privacy law designed to protect you and give you control of your data.