Free templateLash extensions
Lash extensions consent form
A complete, professional lash extensions consent and medical history form. Free to download and print - or switch it on inside Lumela and it is created for you, live, in about a minute.
Already built for you
Don't start from a blank form
You do not have to recreate any of this. Choose lash extensions when you sign up and this exact form appears in your account, ready to send.
What to check before you treat
These are the answers that change whether the appointment goes ahead. The digital version turns the submission red automatically.
- StopHave you ever reacted to lash glue, eyelash extensions or cyanoacrylate?
- StopHave you had a patch test at least 48 hours ago?
- StopDo you have any eye condition, infection or recent eye surgery?
- CheckAre you pregnant or breastfeeding?
- CheckHave you taken isotretinoin (Accutane) in the last 6 months?Skin stays fragile for months after the last dose.
- CheckDo you have eczema, psoriasis, rosacea or active breakouts on this area?
What the form covers
Template wording is a professional starting point, not legal advice. Have your attorney review it for your state.
Paper works. Until it does not.
A printed form has to be filled in at the appointment, filed somewhere, and found again years later. It cannot flag a contraindication, cannot prove when it was signed, and cannot email the aftercare. The same form, sent as a link, does all three.
Get the lash extensions form, free
A complete, printable template written for this treatment. No card, no trial, just the form.
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