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New Client Information & Consent Form

Please complete this form before your first appointment.

Your responses are confidential and will only be used to help ensure your safety, comfort, and suitability for eyelash extension services at Sheer Lash & Beauty.

If you choose not to complete this form online, you will be asked to review and sign a paper consent form when you arrive for your appointment.

First name*

Last name*

Email*

Phone*

Date of Birth*

Year

Month

Day

Have you had eyelash extensions before?*

Yes

Health and Service Considerations

Checking an item does not automatically mean that you cannot receive eyelash extensions. These factors may affect your service, comfort, retention, or whether your appointment should be postponed.

Please check all that apply:

Allergies & Sensitivities

I have an allergy or sensitivity to eyelash adhesives/glue (cyanoacrylate)

I have an allergy or sensitivity to tapes, under-eye gel pads, or latex

I have previously experienced swelling, blistering, or severe itching after getting lash extensions

Autoimmune & Hair Conditions

I have Alopecia (or experience unexplainable hair/eyelash loss)

I have a Thyroid Disorder (e.g., Hashimoto's, Graves' disease, Hypo/Hyperthyroidism)

I have Lupus or another systemic autoimmune condition

I have Type 1 Diabetes

I have Trichotillomania (an urge or habit of pulling out my own hair/eyelashes)

Active Eye & Skin Conditions

I currently have a stye, pink eye (conjunctivitis), or an active eye infection

I have chronic Blepharitis (inflamed, flaky, or crusty eyelids)

I have chronic Dry Eye Syndrome or Chronic Watery Eyes

I have Eczema, Psoriasis, or Rosacea that actively affects my eyelids or face

Recent Medical Treatments

I have had LASIK or permanent makeup/microblading near the eyes within the last 6 months

I have had a blepharoplasty (eyelid surgery) or eye surgery within the last 6 months

I am currently undergoing Chemotherapy or completed it within the last 6 months

I am taking prescription medications that alter hair growth or skin sensitivity (e.g., steroids, Accutane)

Lifestyle & General

I wear contact lenses and understand they must be removed during the service to avoid chemical/fume irritation

I have naturally oily skin or hair, which I understand can shorten extension retention

None of the above apply to me

Additional Information (Optional)

Only include information relevant to your eyelash extension service.

Comfort, Safety & Lash Health

Please review the following information:

Eyelash extension products are used around the eye area and may cause irritation, sensitivity, or an allergic reaction.
Your lash artist will determine the appropriate length, weight, curl, and amount of extensions based on the health and strength of your natural lashes and may modify or discontinue a service when necessary for your safety.
Your eyes will remain closed while you are reclined for an extended period. Please tell your lash artist immediately if you experience burning, pain, or unusual discomfort.
Results and retention vary between clients and cannot be guaranteed.

Aftercare & Policies

I agree to follow the aftercare instructions provided by Sheer Lash & Beauty.
If an allergic reaction develops, I will contact Sheer Lash & Beauty as soon as possible. A complimentary professional removal is available within 48 hours of the service.
If I have concerns about the appearance of my extensions, I will contact Sheer Lash & Beauty within 24 hours of my appointment so they can be assessed.
Completed services are nonrefundable.

Client Acknowledgement

I confirm that the information I have provided is accurate to the best of my knowledge and agree to notify Sheer Lash & Beauty of any relevant changes to my health, medications, allergies, sensitivities, or eye conditions before future appointments.

Photography and Social Media Consent

Photographs or videos may be used for Sheer Lash & Beauty social media, website, portfolio, advertising, or other business marketing.

Declining photo consent will not affect your service.

Please select one option.*

𝐘𝐞𝐬, 𝐟𝐮𝐥𝐥 𝐟𝐚𝐜𝐞: I give permission for photographs or videos that include my full face to be used.

𝐘𝐞𝐬, 𝐥𝐚𝐬𝐡𝐞𝐬 𝐚𝐧𝐝 𝐞𝐲𝐞 𝐚𝐫𝐞𝐚 𝐨𝐧𝐥𝐲: I give permission for photographs or videos of my lashes and eye area to be used, provided my full face is not identifiable.

𝐍𝐨: I do not consent to any photographs or videos being taken during my appointment.

Acknowledgement and Consent

I confirm that the information I have provided is accurate and that I have read and understood the information and policies outlined in this form.

I understand the risks associated with eyelash extension services and voluntarily consent to receiving services from Sheer Lash & Beauty.

I understand that this consent will remain on file for future appointments unless my information changes or an updated consent form is required.

Required Confirmation

I have read and understand all of the information provided in this form.

I understand that my electronic signature on this form has the same effect as signing a paper consent form.

Full Name (Required)*

Electronic Signature*

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Form Completion Date

If you are under 18 years of age, a parent or legal guardian must provide an in person signature before any service can be performed.