Patch Test Record

I have told The Lash Edit about relevant allergies, sensitivities, previous reactions, skin or eye conditions, and any changes to my health that may affect the treatment.

I understand the patch test was carried out according to the relevant product instructions and The Lash Edit’s patch-test policy. I will report any reaction before treatment.

I understand that a negative patch test does not guarantee that a reaction will not occur. The treatment may be postponed or declined if there is a reaction or if it is not suitable on the day.

Suitable to proceed, subject to consultation on the day

	Product / Brand	Batch or lot no.	Test site	Date / time applied
Test 1
Test 2
Test 3

Patch Test Record

Full name

Date of birth

Mobile number

Treatment appointment date

Treatment to be patch tested

Product and Application Record
Record each product tested. Follow the product manufacturer’s instructions.

Application time / method

Product instructions followed by

Patch Test Record

Full name

Date of birth

Mobile number

Treatment appointment date

Treatment to be patch tested

Product and Application RecordRecord each product tested. Follow the product manufacturer’s instructions.

Application time / method

Product instructions followed by

Product and Application Record
Record each product tested. Follow the product manufacturer’s instructions.