TemplatesLash extension
lash extension intake form
The screening on an intake form is identical to the consent form's.
- 14-day trial
- No card needed
- Set up in 10 minutes
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- screening questions
- 9screening questions
- stop the appointment
- 5stop the appointment
- minutes to set up
- 10minutes to set up
- a month to start
- $8a month to start
Lash extension consent
Full name
Date of birth
Email
Phone
Have you ever reacted to lash glue, eyelash extensions or cyanoacrylate?
YesNo
Adhesive reaction history
Why this form, specifically
It photographs the natural lash line before the first set, which is what answers a damage claim you would otherwise have no way to defend.
Look before you download
The whole document, before you give us anything
Lash extension consent
Your details
Full name
Date of birth
This is where your aftercare instructions go.
Phone
Health questions
Have you ever reacted to lash glue, eyelash extensions or cyanoacrylate?
Have you had a patch test at least 48 hours ago?
Do you have any eye condition, infection or recent eye surgery?
This is the form you get
Not a sample, not a preview of a preview. Every question below is in your account ten minutes after you sign up, with the flags already set and the aftercare email already written.
- 14-day trial
- No card needed
- Set up in 10 minutes
- Cancel anytime
The 9 answers that should stop you
The screening on an intake form is identical to the consent form's. What an intake form adds is lash history and a style consultation, which between them prevent the two commonest sources of dissatisfaction: unrealistic style expectations and inherited damage from a previous technician.
Do not treat
5WhyCyanoacrylate adhesives sensitise on repeated exposure. Once a client is sensitised, the next exposure is usually worse and faster, not milder.
What goes wrong if you treat anywaySwollen, weeping lids, sometimes closing the eye entirely, and in a minority of cases an emergency department visit. This is the claim that costs a lash tech their insurance.
What to doDo not apply. A previous mild reaction is not permission to try again with a 'sensitive' glue - sensitisation does not reverse.
The question that catches itHave you ever reacted to lash glue, eyelash extensions or cyanoacrylate?
WhyA delayed hypersensitivity reaction takes 24 to 48 hours to appear. A test done on the day tells you nothing.
What goes wrong if you treat anywayBeyond the client's reaction: most professional lash policies require a documented patch test, and an undocumented one is a declined claim.
What to doPatch test 48 hours ahead, every new client, and re-test after a long gap or a product change. Store the record with a timestamp, because 'we did one' is not evidence.
The question that catches itHave you had a patch test at least 48 hours ago?
WhyThe lid margin is already inflamed and colonised. Extensions trap debris at exactly the point that needs to be kept clean.
What goes wrong if you treat anywayThe infection worsens and spreads, retention is poor, and the client blames the lashes.
What to doPostpone until it is fully resolved and refer to a pharmacist or GP. Blepharitis in particular needs managing before any lash work is sensible.
The question that catches itDo you have any eye condition, infection or recent eye surgery?
WhyPost-surgical eyes are dry, sensitive, and often still on a drop regime that will disturb adhesive cure.
What goes wrong if you treat anywayIrritation, very poor retention, and a client who has spent money twice.
What to doWait until the surgeon has signed them off, usually three months. Ask for that specifically.
The question that catches itDo you have any eye condition, infection or recent eye surgery?
WhyA lift restructures the disulphide bonds in the lash. The lash is porous and the curl fights the extension's line.
What goes wrong if you treat anywayExtensions that will not sit straight and fall within days.
What to doWait two weeks minimum, and set the expectation that retention will still be below normal.
The question that catches itHave you had a lash lift or perm in the last 2 weeks?
Proceed with caution
3WhyThere must be a healthy natural lash to bond to. Sparse or fragile lashes cannot carry weight, and pulling behaviour will strip natural lashes along with extensions.
What goes wrong if you treat anywayPermanent damage to what is left of the natural lash line.
What to doHandle with obvious care. Light, short extensions only, or decline kindly. Clients mid-chemotherapy should have their oncology team's view first.
The question that catches itHave you had any lash loss, thinning or lash-pulling?
WhyNo evidence that adhesive fumes reach the baby, but hormonal shifts change the lash growth cycle, and lying flat on the back for two hours is uncomfortable and, late on, inadvisable.
What goes wrong if you treat anywayPoor retention that reads as bad work, and a physically miserable appointment in the third trimester.
What to doTreat, with the client propped rather than flat, in shorter sessions, and with retention expectations set honestly in advance. Ventilate well.
The question that catches itAre you pregnant or breastfeeding?
WhyProstaglandin analogues change the lash growth cycle and are associated with lid irritation and pigmentation.
What goes wrong if you treat anywayUnpredictable shedding, irritation that gets attributed to the adhesive, and disappointing retention.
What to doTreat, but document it and set expectations. Ask them to pause a cosmetic serum, never a prescribed drop.
The question that catches itDo you use any eye drops or lash growth serum?
Safe to proceed
1WhyNot a contraindication. Lenses simply must come out before the eye is taped closed for two hours.
What goes wrong if you treat anywayLeft in, the client ends the appointment with dry, gritty, irritated eyes and blames the glue.
What to doAsk them to remove lenses before you start and bring a case. Say it in the booking confirmation, not on arrival.
The question that catches itDo you wear contact lenses?
What you actually get
Nobody buys a consent form
They buy the fifteen minutes back at the start of an appointment. They buy the phone call they did not have to make, because the contraindication turned up two days early instead of two minutes late. They buy an insurer who pays out, because the patch test has a timestamp rather than a memory attached to it.
The form is the mechanism. What you are actually buying is the record it leaves behind.
That is the whole argument, and it is why the questions matter more than the software. A blank form builder hands you a canvas and calls it flexibility. This hands you the nine questions that a waxing client should be asked, in the wording that gets an honest answer, with the risky one already flagged in red.
What this saves you
Not what the form contains - what it gives you back. Every number below is arithmetic you can check on the calculator further down the page.
A defensible claim
instead of a disputed memory
Most professional policies in these trades condition cover on documented screening, and a patch test you can describe is not a patch test you can produce. A timestamped record is the difference between a claim your insurer defends and one they decline.
4 seconds
from signature to aftercare email
The aftercare for their treatment lands in their inbox before they have left the chair, written for that service and editable in your words. Clients who follow aftercare heal better, complain less and rebook more - and you did nothing.
12 hours
a year, back in your chair
A new client filling in a paper form in your treatment room costs ten to fifteen minutes of an appointment they already paid for. Send it with the booking confirmation and that time goes back into treating, at roughly twelve hours a year on twenty clients a week.
Seconds
to find any client's form
The reason to leave paper is not the signing, it is the finding. When a health inspector or a solicitor asks for one specific record from eighteen months ago, you search a name instead of an afternoon.
Same week. One thing changed.
The left-hand column is most studios today. The right-hand one is the same week with the form sent at booking instead of handed over on arrival.
- You patch test, but the record is a note in your phone
- Set seven, and her lids swell overnight
- The insurer asks for the patch test record
- You have one from two years ago, on paper, in a box
Nothing here is negligent. It is just undocumented.
- Every patch test is dated, timed and stored against her name
- The system flagged that she was due a re-test after your glue change
- Set seven happens on a client you tested last week
- If it goes wrong anyway, you can produce the whole history in seconds
Same treatments, same clients, same you. Different record.
Try the flag
Answer these as if you were the client
Answer honestly and nothing happens. Answer yes to the one that matters and watch what lands on your side.
What the client sees
Have you ever reacted to lash glue, eyelash extensions or cyanoacrylate?
Have you had a patch test at least 48 hours ago?
Have you had any lash loss, thinning or lash-pulling?
Are you pregnant or breastfeeding?
What you see
Answer honestly and nothing happens. Answer yes to the one that matters and watch what lands on your side.
In your submissions list
Lash extension
What goes wrong without it
A new client arrives with a set applied elsewhere, asks for a full removal and a mega-volume set, and gets one.
Her natural lashes were already compromised - stuck bases, several lashes carrying two extensions - which the technician noticed and mentioned verbally. Six weeks later the client's lashes are visibly sparse, and she attributes it entirely to the new set. The technician's assessment was correct and was never written down or photographed. Every fact in the dispute is contestable except the one that matters: nobody can now say what the lashes looked like before.
What a lash extensions intake form has to cover
The actual field list, and why each group is on this particular form.
Contact and booking
- Full name
- Date of birth
- Phone
- How did you hear about us
Lash clients arrive through Instagram more than any other trade in this list, and the handle is how the before-and-after gets tagged.
Lash history
- Worn extensions before
- Where and when
- Style previously worn
- Retention experienced
- Any problems or reactions
- Current natural lash condition
- Lash serum use
Asking where they went before is not nosiness. A client coming from a different technician often has weight or isolation problems on the natural lash that need addressing before anything new goes on.
Style consultation
- Desired look
- Eye shape and lash line assessment
- Curl, length and thickness selected
- Mapping notes
- What is achievable on this natural lash
'What is achievable on this natural lash' is the field that prevents the mega-volume request on lashes that cannot carry it, and it is much easier to write down before the set than to explain after it.
Patch test, medical and consent
- Patch test date, time and result
- Full allergy and eye screening
- Aftercare acknowledgement
- Infill schedule agreed
- Consent, photo permission and signature
Even on an intake form, the patch test record is the field with the most value per character. Everything else improves the appointment; this one protects the business.
Is a digital signature legally valid?
Exact time signed
IP address
Device and browser
The exact form they saw
Yes - the US ESIGN Act and the state UETA adoptions give it the same legal effect as ink. What makes it hold up is the evidence stored beside it, and a paper form in a drawer carries none of this.
Sign with your fingerDraw a signature with your mouse or trackpad
Where you stand legally
The intake form is not the consent record, and the practical risk is treating it as though it is. Insurance conditions attach to the patch test and the contraindication screening, and those need to sit under a signature with a consent statement rather than at the end of a questionnaire. Where an intake form does carry independent weight is in the style consultation: a documented assessment of what the natural lash can support, agreed before application, is the answer to a damage claim brought after a set that was too heavy. Natural lash damage from excessive weight is the most common lash complaint after allergy, and it is genuinely difficult to defend without a record of what the lashes looked like at the start. Photograph the natural lash line at the first appointment and attach it. On data, be conservative: the form collects contact details and medical information from people who may never book, so set a deletion point for unconverted enquiries. Not legal advice.
Paper, PDF or digital?
Paper
Fine when you are small
- Signed before they arrive
- Flags contraindications
- Findable by name in seconds
- Proves when it was signed
- Sends aftercare automatically
- Costs nothing
Emailed PDF
Worst of both
- Signed before they arrive
- Flags contraindications
- Findable by name in seconds
- Proves when it was signed
- Sends aftercare automatically
- Costs nothing
Digital
Earns its place at scale
- Signed before they arrive
- Flags contraindications
- Findable by name in seconds
- Proves when it was signed
- Sends aftercare automatically
- Costs nothing
Three clients a week? Print it and staple it in a binder. That is genuinely fine, and software would be an expense with no return. Digital earns its place around ten to fifteen clients a week, when finding one form again matters more than the minutes it took to file it.
Questions people actually ask
Lash history, previous technician and retention experienced, current natural lash condition, and the style consultation with what is realistically achievable. Those four fields prevent the two most common complaints in lash work.
Your form is written. Come and get it.
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General guidance for professionals, not legal or medical advice. Check the rules that apply where you work.