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Eyelash Extension Consultation Form

You will have the opportunity to discuss any questions or concerns you have about this optional, cosmetic service.

Potential Allergies

By checking the box in the consultation form which has sent you to this page,  and proceeding with your lash appointment you acknowledge that; eyelash extensions carry certain inherit and possible risks of allergic reactions at any time (including, but not limited to) redness, irritations from the chemicals in the glues used, itching, swelling, and/or other symptoms of ocular distress that are beyond your practitioners responsibility or control.

It is strongly advised to go to your doctor.  The adhesives and adhesive removers are both an eye and skin irritant, and you can become allergic to the ingredients in the adhesive, as well as any product used to prep, at any time.

If you need to seek medical attention, you must do so and at your own expense.  

There are no refunds for this service once applied, as time and services have been rendered. 

Removal within 48 hours is complementary, otherwise a removal fee will apply.

If you experience any discomfort in the first 24-48 hours after application, please call to have the extensions removed.  

You will have the opportunity to discuss lash lengths, ask any questions, and discuss concerns and risks.

During the Appointment

I understand that I must keep my eyes closed and remain still during the procedure.  Some cases may result in complications such as eye redness, irritation, or allergic reactions. If at any time during the eyelash extension procedure I feel uncomfortable, I agree to immediately notify my lash technician at Designer Lashes.  They will seek to remedy the problem, including ending the session if deemed prudent.  I acknowledge that no guarantees or promises regarding the appearance or longevity of the lash extensions have been made.  I understand that eyelash extensions require careful maintenance.  Steam, heat, friction and sleeping on sides or stomach may weaken the bond and result in premature lash extension loss.  I understand that oil based cosmetics as well as waterproof mascara will weaken the bond.  Manual curlers will break the lashes off.  

I understand that the lash extensions will grow out with my natural lashes, and due to my natural lash cycle, I will shed approximately 1 – 5 lashes a day.  I hereby certify I have disclosed all conditions regarding my health history, medications and past reactions to products, treatments and medications in Consent Form.


By checking the box in the consultation form, I, the client named in the form certify that I knowingly and voluntarily release my lash technician and Designer Lashes from any and all claims for damages for personal injury arising from the application and use of semi-permanent eyelash extensions, including any damages relating to known or unknown complications which may arise during or following the application process including but not limited to claims for negligence.  I further release and hold harmless Claire Carmichael and Designer Lashes from any claims relating to preexisting conditions I have not revealed or changes to those conditions subsequent to this procedure and any procedures in future.

I understand that the booking for any full sets is non -refundable as it secures my appointment.

I understand that 48 hours notice is applicable if I wish to reschedule a full set, and 24 hours notice for an infill. 

Any no shows or last minute cancellations (within four hours of the appointment) will result in a charge of 100% of the appointment booked as these appointments are unable to be filled.

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