Consent Forms

Review each treatment consent form here. Logged-in clients can update their saved answers; guests can print any form and log in to submit it online.

Brow Henna Consent Form Brow Lamination Consent Form Brow Wax & Tint Consent Form Dermaplaning Consent Form Lash Extensions Consent Form Lash Lift Consent Form Microneedling Consent Form

Lash Lift Consent Form

Version 2026.03.17
Register or log in to complete and submit this form online. Guests can still print this page for offline use.

Client Information

Health History

Have you had a lash lift in the past?
Do you have any allergies?
Do you wear glasses?
Do you wear contact lenses?
Do you currently have any eye illnesses/conditions?
Do you use any eye drops/medication?
If so, please list
Do you have an allergy to adhesives/band-aids or medical tape?
Do you have an allergy to surgical glue or nail glue?
Do you have seasonal allergies?
Have you reacted to any beauty or eye products?
Do you have, or have you ever had, any of the following: epilepsy or herpes?
Do you have any inflammation or injury near your eyes?
Do you currently wear eye makeup?
Have you had an eye lift?
Are you taking any medications that can cause temporary hair loss?
Have you had a major surgery within the last 24 days?

Consent & Liability

I understand there are risks associated with having a lash lift and/or lash tint. I further understand that, as part of the procedure, eye irritation, eye pain, eye itching, discomfort, and, in rare cases, an allergic reaction, eye infection, or blurred vision could occur. You may request a patch test at least 24 hours before your appointment. I agree that if, at any time, I am uncomfortable with the lash lift and/or lash tint treatment, I will inform the technician and she will gladly rectify the problem, including ending the session.

I understand and consent to have my eyes closed and covered for the duration of the procedure.

You must prepare your eye area prior to your arrival. Eyelashes should be clean, dry, and free of mascara, makeup, and oil residue. If you attend your appointment without proper preparation, Aliya's Beauty cannot guarantee lasting or satisfactory results. Please let us know if you have any mascara or residue on your lashes.

I understand that, while every attempt will be made to provide me with my chosen color, everyone's hair absorbs color differently and the result may not be the color I initially wanted.

For optimum results, avoid direct heat, steam, mascara, and other skin care products around your eye area for 24 hours after the application.

There are no guarantees for the length of time your lash lift and/or lash tint will last. I understand the aftercare instructions and will do my part to maintain my eyelashes. I understand that there are many factors that may affect the life of the lash lift and/or lash tint, such as water or moisture contact, weather conditions, and activities involving exposure to high temperatures.

We suggest checking with your doctor prior to having a lash lift and/or lash tint if you are pregnant, nursing, have chronic dry eye, conjunctivitis, eye infections, trichotillomania, have recently undergone chemotherapy, or have recently had LASIK or blepharoplasty surgery.

A lash lift and/or lash tint may not be suitable for you if you have damaged lashes, lashes with gaps, or extremely short natural lashes.

I acknowledge that the results of a lash lift and/or lash tint vary and that no guarantees of specific results are offered or implied. I take sole responsibility for any reaction I may have, including staining of clothing and/or personal belongings. I agree to hold Aliya's Beauty and all authorized representatives harmless from any liability involved in the lash lift and/or lash tint process. Aliya's Beauty and its staff have explained this procedure to me, and all my questions, if any, were answered.

I have reviewed and completely understand all the information given to me, including this form. I give Aliya's Beauty permission to take, publish, and reproduce photographs of me, my face, and/or my eye area, both before and/or after the procedure for advertising and other purposes.

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