Eyelash Extension Consultation Form Template – US

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Updated – 2025 /2026


Important Notice

This document outlines the preliminary details for a client consultation regarding eyelash extension services. It is provided for informational purposes only and does not substitute professional advice or consultation with a licensed beauty specialist. Specific procedures, safety standards, and legal considerations may vary by region, and it is recommended to seek personalized guidance to ensure compliance and safety. The use of this information is at your own discretion, and we accept no liability for any errors or omissions resulting from its application without professional consultation.


PDF

PDF

Word

Word

Sample

Sample

Template

Template


Please note: This is a sample Eyelash Extension Consultation Form template for illustrative purposes only. Actual content may vary based on specific client needs and applicable regulations.

Eyelash Extension Consultation Form (Sample Template)

Client Details:

Name: ____________________________________________
Contact Number: __________________________________
Email: ____________________________________________

Medical & Eye History:

Do you have any allergies to cosmetics or adhesives? _______________________
Are you pregnant or nursing? _______________________
Do you wear contact lenses? ____________ (Yes/No)

Services Requested:

Type of eyelash extensions: _______________________________
Shape and length preferences: _____________________________
Special considerations or concerns: ______________________

Consent & Precautions:

I confirm that I have disclosed all relevant medical information and understand the procedures involved. I agree to follow aftercare instructions provided by the technician.

Signature: ________________________________ Date: ________________

Technician Comments:

__________________________________________________________

Please arrive 10 minutes early for your appointment. Notify us of any sensitivities or concerns prior to the session.