Eyelash Extension Consent Form: What It Should Cover (Free Printable)

By the WIPE team · Updated October 21, 2026 · 10 min read

The short answer: an eyelash extension consent form should collect the client's contact details, ask the health questions that matter around the eyes (allergies, especially to latex or adhesive ingredients, eye or eyelid irritation or infection, recent eye surgery, contact lenses, hair loss conditions, chemotherapy, pregnancy), explain the known risks in plain words, record whether a patch test was done or declined, confirm she has received aftercare instructions, ask separately for photo permission, and end with her signature and yours, with a date. Review it with her before every appointment, not only the first. Our free lash consent form maker prints one with your business name. This guide is general information, not legal or medical advice.

Is a consent form legally required for lash extensions?

It depends on your state, and the rules change. What is consistent is who regulates you: your state's cosmetology or barbering and cosmetology board. In California, for example, the Board of Barbering and Cosmetology says applying eyelash extensions is "only within the scope of practice of licensed cosmetologists and estheticians" (California BBC industry bulletin, 07-2022). Other states license lash work differently, some with a separate specialty license.

Even where no statute names a "consent form", most lash artists use one, for three practical reasons:

1. It catches the client who shouldn't be in your chair today. An irritated eye or a known latex allergy is much easier to spot on paper than in the middle of a conversation.
2. It shows you explained the risks. If a client has a reaction, a signed form shows what she told you and what you told her.
3. Insurers and training programs often expect it. If you carry liability insurance, ask your insurer what they want to see on file.

Before you rely on any template, including ours, ask your state board or a local professional to check it.

What should an eyelash extension consent form include?

A good form is short enough that clients actually read it. These are the sections most lash artists use, in the order a client fills them in:

1. Client details: name, phone, email, date of birth (some artists only serve adults, and it helps if you need to contact her later).
2. The service booked: classic, hybrid, volume, lash lift, tint, removal. If you add a service later, update the form.
3. Health questions: see the list below.
4. Risks she understands: a short list in plain words, taken from reliable sources rather than scary language.
5. Patch test: done (date and result), declined, or not required, with her initials.
6. During the service: eyes closed, tell me right away about any stinging or burning.
7. Aftercare: confirmation that she has received written aftercare instructions and understands that following them affects retention and comfort.
8. Photo permission: a separate yes or no for using photos of her lashes on Instagram or your website.
9. Your policies: one line confirming she has read your booking and cancellation policy, with a link.
10. Signatures and date: hers and yours.

Which health questions belong on a lash intake form?

The California board's consumer leaflet is a useful, public starting point. It lists the "unfavorable results" lash extensions can have, "including but not limited to: allergic reaction, irritation, burning, redness, and soreness", and says that in most cases lashes should not be applied to people who have alopecia, are undergoing chemotherapy or radiation, or have trichotillomania (California BBC, Eyelash Extensions Safety Tips). The same leaflet tells consumers not to get extensions if the eye or eyelid is "irritated, inflamed, infected", or if they are allergic to latex or any adhesive ingredient.

• Do you have any allergies, including latex, adhesives, cyanoacrylate or formaldehyde? Allergic reactions to adhesive are a known risk. The CA board tells consumers to ask for a formaldehyde-free adhesive.
• Is either eye or eyelid irritated, red, infected or recently injured right now? The CA board says not to apply extensions to an irritated, inflamed or infected eye.
• Have you had eye surgery (including LASIK or cataract) recently? Ask her to check with her eye doctor before booking.
• Do you wear contact lenses? She'll need to remove them for the service.
• Do you have alopecia, trichotillomania, or are you having chemotherapy or radiation? The CA board says that in most cases lashes should not be applied in these situations.
• Do you have dry eye, blepharitis or another eye condition? Extensions can make lid hygiene harder; she may want to ask her eye doctor first.
• Are you pregnant or breastfeeding? Many artists ask, because some clients become more sensitive to fumes or products. Let her decide with her doctor.
• Have you had a reaction to lash extensions, lifts or tints before? The best predictor you have.
• Are you currently using a lash growth serum or prescription eye drops? Some serums and drops affect the lashes or the eye area.

Keep the questions factual. Don't ask for diagnoses you can't interpret, and don't give medical opinions. If an answer worries you, the safest reply is "please check with your eye doctor, and let's rebook when you're cleared".

Should you do a patch test before lash extensions?

Many artists offer one, and some require it for every new client. The California board describes a patch test as applying "a small amount of the adhesive to a part of your skin", waiting 24 hours and watching for a reaction, and it suggests consumers ask for one if they are unsure about an allergy (California BBC).

A patch test doesn't guarantee that a client won't react later. Sensitivity can build up over repeated sets. That's why the form should ask about reactions at every visit, not just the first.

On the form, give three boxes: patch test done on [date], no reaction; patch test declined; not offered for this service. Have her initial whichever applies.

What about lash lifts and tints?

If you offer lifts or tints, the form needs a few extra lines.

• Tints: the FDA warns that permanent eyelash and eyebrow tints and dyes have "caused serious eye injuries, including blindness", and its list of approved color additives for tinting lashes and brows is very short (FDA, Eye Cosmetic Safety). Check the ingredients of the tint you use and how your state treats it, and ask clients about past reactions to hair dye.
• Lifts: in California, lash perming sits within the scope of licensed barbers, cosmetologists and estheticians (California BBC bulletin). Ask about sensitivity to perm solutions and recent lifts.
• Growth serums: the same California bulletin notes that applying a drug-based prescription product "may constitute the practice of medicine" and is outside a board licensee's scope. Don't apply prescription lash products, and don't promise growth.

How should the risks section be worded?

Use calm, specific language. Clients sign forms they understand. They hesitate at forms that read like a hospital waiver.

• Name the real risks without exaggerating them: allergic reaction, irritation, redness, soreness, and possible damage to natural lashes if extensions are picked or pulled. The American Academy of Ophthalmology has also warned about infection of the cornea or eyelid, swelling, and temporary or permanent lash loss (Ophthalmology Times on the AAO warning).
• Say what she should do if something feels wrong: tell you immediately during the service, contact you afterwards, and see a doctor if her eyes are red, swollen, painful or her vision changes.
• Avoid promises. "Your lashes will last four weeks" becomes a dispute. "Retention depends on your natural lash cycle and aftercare" doesn't.

How long should you keep signed forms, and where?

There's no single national rule for salons. Record-keeping requirements vary by state, so ask your board. In practice:

• Paper: store signed forms in a locked drawer or cabinet, not in a folder on your lash bed.
• Digital: if your booking tool has intake forms, use its form and keep the account protected by a strong password and two-step login.
• Review before each visit. Ask "anything changed since last time? New medications, allergies, eye issues?" and note the date.
• Don't share it. The form contains health information. Don't post it, forward it, or leave it on a shared tablet.

Free printable eyelash extension consent form

Edit everything in [brackets]. This is a template, not legal or medical advice; check it with your state board or a local professional before you use it.

Eyelash extension consent and intake form, [Business name]

Client: Name ________ Phone ________ Email ________ Date of birth ________

Service today: [ ] Classic [ ] Hybrid [ ] Volume [ ] Fill [ ] Removal [ ] Lash lift [ ] Tint

Health questions (circle yes or no): Allergies, including latex, adhesive, cyanoacrylate or formaldehyde: Y / N. Eye or eyelid irritation, redness or infection now: Y / N. Eye surgery in the last [6] months: Y / N. Contact lenses: Y / N. Alopecia, trichotillomania, chemotherapy or radiation: Y / N. Dry eye, blepharitis or another eye condition: Y / N. Pregnant or breastfeeding: Y / N. Previous reaction to lash extensions, lifts or tints: Y / N. Using a lash serum or prescription eye drops: Y / N. Details: ________

I understand that: lash extensions are applied to my natural lashes with a cosmetic adhesive; possible reactions include allergic reaction, irritation, burning, redness and soreness; picking or pulling extensions can damage my natural lashes; retention depends on my natural lash cycle and on aftercare; and I should tell [artist name] immediately if I feel stinging or discomfort during the service, and see a doctor if I have redness, swelling, pain or changes in vision afterwards.

Patch test: [ ] Done on ____ with no reaction [ ] I declined a patch test [ ] Not offered for this service. Initials ____

Aftercare: I have received written aftercare instructions. Initials ____

Photos: [ ] Yes, you may post photos of my lashes (no full face without asking). [ ] No photos, please.

Policies: I have read and agree to the booking and cancellation policy at [link]. Initials ____

Client signature ________ Date ____ Artist signature ________ Date ____

This form is a template and not legal or medical advice.

Prefer not to edit by hand? The lash consent form maker adds your business name, includes lift and tint questions when you choose those services, and prints or saves as a PDF in your browser. Nothing you type is sent anywhere.

How to use the form in your booking flow

1. Send it before the first appointment, with the confirmation, so she can read it at home instead of in your chair.
2. Review it together for two minutes at the start. Most important line: "Anything I should know about your eyes today?"
3. Re-check at every fill. One question and a date is enough.
4. Link your policy and aftercare. The consent form, your cancellation policy and your aftercare instructions work as a set; clients who get all three ahead of time tend to arrive prepared.

If your booking still happens in DMs, those links have nowhere to live. WIPE turns your Instagram into a booking site you can build and preview free, with your services, prices and a Book button in one place. It also includes a lash extension consent and intake template that clients sign online on your site before the visit, with the signed copy saved to their record as a PDF (a template, not legal advice, so check it against your state's rules), or you can keep using your printable form. Here's what a WIPE site includes for lash artists.