Lash Extensions Consent | Beauty Habitz

1. Client Details

Full Name *

Phone *

Email *

Date of Birth *

Address

Have you had lash extensions before? *

Yes No

If yes, when was your last set?

Did you have any issues (e.g. irritation, allergic reaction)? *

Yes No

If yes, please explain

Do you suffer from any of the following? (Please tick)

Do you use any lash serums or eye products? *

Yes No

If yes, please list

Have you had any eye surgery (e.g. LASIK)? *

Yes No

If yes, please specify

What look are you wanting? (Please tick)

Desired style *

Natural Classic Hybrid Volume Mega Volume Other (please specify)

Other style

Lash extensions require regular infills to maintain the best results.
It is important to follow the aftercare advice to avoid premature loss or damage.
I understand that lash extensions may not be suitable if I have certain eye conditions, allergies or medications.
I understand that results can vary between individuals and are not guaranteed.

I have read and understood the information above and I give consent to receive lash extensions.
I understand the risks, benefits and aftercare requirements and agree to follow the aftercare advice provided.

I have read and accept the treatment consent above. I have read the privacy collection notice and understand how my information will be handled.

Client signature *

When submitted, the form version, answers, signature, timestamp and evidence checksum are stored as a locked consent record.