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Eyelash Consent Form

I understand that this procedure requires single eyelash extensions to be glued to my own natural lashes. It is my responsibility to keep my eyes closed and to be still for the duration of the procedure.

I understand the fumes from the adhesives may cause my eyes to tear up if I open my eyes during the procedure.

I agree to disclose all allergies that I may have to latex, surgical tapes, petroleum jelly (Vaseline), Cyanoacrylate, adhesives, lash bath wash etc.


I understand that I am required to follow the Eyelash Extensions aftercare listed below in order to maintain the life of my extensions.


It’s very common for the eyes to become dry or red during the lash application process. We recommend using red eye Visine drops after the application if you find it necessary.


Please keep your eyes closed for 5 minutes after the procedure to allow the adhesive to completely dry.


Warning: opening eyes before 5 minutes may cause a stinging sensation in your eyes. You may NOT open your eyes during any lash procedure to look at your phone. You may not chew gum as it moves your face and is a choking hazard.


NOTE: if you have any problems with my work, please send me an email to We will discuss all issues and I will do everything I can to fix it. If your eyes feel uncomfortable when you get home, please give it 24 hours to feel better, if that feeling persists, please send me an email with all details of what you’re feeling. If you find this may be an emergency, call 911 or get someone to drive you to the hospital. DO NOT drive if your vision is impaired.



  1. Rescheduling or cancelling any salon appointment requires a minimum notice of 24 hours. If you do not give at least 24 hours notice before cancelling an appointment you will be responsible for paying a $40.00 cancellation fee, this is the same for any no show appointments where no notice is given. This is to ensure our technicians are paid for their time as with less than 24 hours notice, that appointment time will likely not be filled by another client.

  2. In order for any eyelash appointment to qualify as a “fill” the client must have at least 50% of their extensions remaining on their natural lashes when they show up for their appointment, otherwise the appointment with be charged as a “full set” not a “fill”.



  1. Do not wash eyes or shower and avoid steam and sweat for 24 hours after application

  2. Avoid strong heat such as ovens, BBQs, saunas etc.  Heat can melt or distort extensions

  3. Avoid rubbing and pulling eyelashes

  4. Avoid all oil-based makeup removers or facewashes

  5. Do not use eyelash curler or mascara on your extensions

  6. Clean your eyelashes with an oil-free lash bath every 2-3 days with a professional lash bath shampoo  

  7. Book a fill appointment every 2-3 weeks to fill in the areas where your natural lashes have fallen out and new lashes are growing in (50% of extensions required to qualify as a fill)

I agree that by reading and signing this consent form I release Doll House from any claims for damages of any nature. I agree that I have read and fully understood this consent form and all of the content within it. I am of sound mind and fully capable of executing this waiver for myself.


Doll House will not be held liable for any damage that you may cause by trying to remove the eyelash extensions on your own or not preforming the proper after care.

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