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Lash Extensions Client Intake

Your Information

First Name *

Last Name

Phone

Date of Birth *

Have you had lash extensions done before? *

Allergies or Sensitivities *

List any known allergies (adhesives, latex, etc.) or eye sensitivities and wear contact lenses.

Eye Conditions and Contraindications *

Have you had any eye surgery, infections, or conditions in the past 6 months?

Do you exercise and/or are outdoors regularly?

Exercise & outdoor environment can affect the retention of lashes. This will help me assess the best customization for your set.

Desired Lash Style *

I understand there is a risk of irritation or allergic reaction and I consent to proceed *

I understand I should not wear mascara or curl my lashes before my appointment *

I understand lash extensions require regular maintenance every 2-3 weeks *

I understand individual results may vary depending on my natural lash cycle, lifestyle, and aftercare *

I agree to inform my lash artist immediately if I experience burning, discomfort, or pain during the appointment *

I understand rubbing, pulling, or picking at my extensions can damage my natural lashes *

I understand proper cleansing with a lash-safe cleanser is necessary for healthy retention *

I understand no guarantee is made regarding the retention of my lashes and how long the may last *

Photo & Social Media Consent *

May we photograph your results and share them on our social media or website?

Signature *

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