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Eyelash Care at the Hairdresser
lash services
Date
Gender
Male
Female

****IF UNDER 18 YEARS OF AGE MUST HAVE PARENT CONSENT TO RECEIVE SERVICE.

Have you been here before?
Yes
No
Have you ever had eyelash extensions before?
Yes
No
Do you currently have lash extensions on?
Yes
No
Have you had eyelash extensions removed?
Yes
No
Have you used under eye gel pad or patches before?
Yes
No
Do you have extremely oily skin or/and hair?
Yes
No
Have you had permanent cosmetics applied to your eye?
Yes
No
Do you wear contacts?
Yes
No
Are you allergic to any tape, paper tape, adhesives, bandages, or band-aids?
Yes
No
Do you repeatedly rub or pull on your lashes?
Yes
No
Can you keep your eyes closed and lie still for up to 2 hours?
Yes
No
Do you have any eye allergies that affect your eyes, skin, digestive, or respiratory system?
Yes
No

There is a chance you could have an allergic reaction to the primer, glue, or other products used during the lash extension service. We offer a patch test to check for allergies. If you choose not to do the patch test, you accept the risk of any allergic reactions during the lash extension service.


PLEASE CHECK THE APPROPRIATE BOX BELOW:

I HEREBY RELEASE THE LASH ARTIST AND INFINITY LASH STUDIO FROM LIABILITY IF I DEVELOP AN ALLERGIC REACTION.

DO YOU CONSENT TO THE PATCH TEST?
Yes
No
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