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LASH EXTENSION CONSULTATION
Lash Extension Consultation
Please complete before your appointment. Your answers help me understand your lash history, sensitivities and preferred style.
YOUR DETAILS
Full name
*
Date of birth
*
Mobile number
*
Appointment date
*
YOUR LASH HISTORY AND PREFERENCES
Have you had lash extensions before?
*
A
Yes
B
No
If yes, when was your most recent set or infill?
*
Have you ever reacted to lash adhesive, extensions, tape or eye pads?
*
A
Yes
B
No
What would you like today?
*
Full set
Infill
Removal
Preferred style
*
Classic
Double Classic
Angel
Hybrid
Preferred finish
*
Natural
Soft
Full
Not sure
HEALTH AND SENSITIVITY CHECK
Please tick anything that applies and add details below. If none apply, tick “None”.
Health and sensitivity status
*
Current eye irritation, infection, inflammation or excessive watering
Known sensitivity or allergy to lash adhesive, cosmetics, tape or gel pads
Previous reaction to lash extensions or an eye-area treatment
Eye condition or recent eye surgery
Contact lenses worn (please remove before treatment)
Natural lashes currently damaged, weak or recently treated
Other relevant allergy, health concern or medication
None of these apply
Details (including any previous reactions or sensitivities)
*
THE LASH EDIT: Consent and treatment record
BEFORE WE BEGIN
I confirm and understand the following:
*
I confirm that the information I have provided is accurate and complete. I will tell my technician if anything changes before my appointment.
I understand lash extensions may cause irritation or an allergic reaction, and that the treatment may be postponed or declined if my answers, lash condition or patch test result indicate it may not be suitable on the day.
I have had the opportunity to ask questions. I understand that retention and results vary, and I agree to follow the aftercare instructions provided.
I understand that infills depend on the condition and retention of my existing extensions; removal and a new set may be recommended if they are not suitable to infill.
CONSENT: Do you consent to the lash extension treatment discussed today?
*
A
I consent to the lash extension treatment discussed today.
B
I do not consent to treatment today.
Client signature
*
Sign here
Date
*
OPTIONAL PHOTO CONSENT
May I take before-and-after photos for your treatment record?
*
A
Yes
B
No
May I share photos on The Lash Edit’s social media?
*
A
Yes
B
No
TECHNICIAN USE ONLY
Patch test checked
*
Natural lash condition / notes
*
Style and mapping
*
Products / adhesive details
*
Aftercare provided
*
Technician signature
*
Technician signature
Date
*
Removal required
*
A
Yes
B
No
Submit
