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Lash Extension Client Intake & Consultation Survey

A pre-appointment intake for lash extension clients that captures allergy risk factors, eye health flags, style goals, and lifestyle habits that affect retention. Built for lash studios and freelance lash artists to prep safely and customize the service. The AI follow-up interview digs into the client's past lash experiences and true expectations so artists can set realistic looks and avoid repeat reactions.

Sample questions

A preview of what’s in the template. Every question is editable before you launch.

13 questions · ~7 min
Q01
Message

Welcome! Before your lash appointment, we'd love a few quick details about your eyes, skin, and the look you're going for so your artist can prep safely and get it right the first time. About 7 minutes.

Q02
Multiple ChoiceRequired

Have you had eyelash extensions applied before?

  • No, this is my first time
  • Yes, occasionally
  • Yes, I get regular fills/refills
  • Not sure
Q03
Multiple ChoiceRequired

Do you have any known allergies or sensitivities to any of the following?

  • Latex
  • Lash adhesive/glue (cyanoacrylate)
  • Fragrances or perfumes
  • Numbing or antihistamine eye drops
Q04
Multiple ChoiceRequired

Which of the following currently apply to you? (Select all that apply)

  • I wear contact lenses
  • I've had eye surgery in the last 6 months
  • I use retinol or other active skincare near my eyes
  • I have a history of styes, conjunctivitis, or eye infections
  • I am pregnant or breastfeeding
  • I am currently taking blood thinners
Q05
Multiple ChoiceRequired

How would you describe your natural lashes?

  • Strong and thick
  • Normal/average
  • Fine, sparse, or brittle
  • Not sure
Q06
Multiple ChoiceRequired

What look are you hoping to achieve with your lash extensions?

  • Natural and subtle
  • Wispy/textured
  • Full glam/dramatic
  • Not sure — open to my artist's recommendation
Q07
Opinion Scale

If you've had lash extensions before, how would you rate how long they typically lasted before you needed a fill?

Scale: 17
Min:Fell out very quicklyMax:Lasted the full recommended cycle
Q08
Multiple ChoiceRequired

Which of these are part of your regular routine? (Select all that apply)

  • I swim regularly
  • I use oil-based cleansers or moisturizers near my eyes
  • I sleep on my side or stomach
  • I use saunas or steam rooms regularly
  • I wear eye makeup most days
  • I rub or touch my eyes often
Q09
AI Interview

Explore the respondent's true expectations and history with lash extensions: if they've had them before, ask what they loved, what went wrong (irritation, poor retention, style regret), and why they're returning or switching artists. If it's their first time, probe what's driving them to try extensions now and any anxieties about the process, pain, or maintenance. Anchor follow-ups on their stated style goal and lifestyle habits to surface any mismatch between what they want and what's realistic for their eyes and routine.

Q10
Photo response

Please upload a close-up photo of your bare natural lashes (no makeup, no extensions) so your lash artist can plan the right length, curl, and thickness.

Q11
ConsentRequired

Before-and-after photo/video consent

Q12
Multiple Choice

What's your age range?

  • Under 18
  • 18-24
  • 25-34
  • 35-44
  • 45-54
  • 55-64
  • 65+
  • Prefer not to say
Q13
Message

Thank you! Your answers go straight to your lash artist to help them choose safe products and the right style before your appointment starts. See you soon!

What’s included

  • AI follow-ups

    Adaptive probes on open-ended answers that pull out detail a static form would miss.

  • Attention checks

    Built-in safeguards against rushed answers and low-quality respondents.

  • AI-drafted copy

    Wording, ordering, and branching written by the AI — tuned to your research goal.

  • Auto report

    Themes, quotes, and a plain-English summary write themselves once responses come in.

How it compares

We reviewed the closest templates from other survey tools. Here’s what they do well — and where this template goes further.

Why this template

  • Goes beyond a static checklist by pairing structured allergy, eye-health, and lifestyle questions with an AI follow-up interview that probes the client's actual lash history and expectations, helping artists avoid repeat reactions.
  • Includes a dedicated photo upload of bare natural lashes plus a before-and-after photo/video consent step, giving artists visual reference and documented permission in one flow.
  • Captures style-goal and routine questions (skincare/makeup habits affecting retention) alongside age-range and allergy multiple-choice questions, so intake covers both safety and aesthetic planning.
  • Bookends the survey with friendly chat messages that set expectations up front and confirm next steps at the end, keeping the intake feeling personal rather than clinical.

Jotform

Lash Extension Intake Form Template

A ready-to-field, lash-specific intake form that likely covers allergy history and basic client details, built on Jotform's drag-and-drop form builder. It's a static form template meant to be customized and embedded, not an interactive interview experience.

What it does well

  • Purpose-built for lash extension intake so fields are already relevant to the use case
  • Easy to customize and embed via Jotform's widely-used form builder
  • Likely supports e-signature and file upload widgets for consent-style fields

Where it falls short

  • Static question set with no adaptive AI follow-up to dig into a client's true history or expectations
  • No voice AI interview option or per-response quality scoring
  • No published methodology for how questions were designed or scored

Typeform

Lash Extension Intake Form

A conversational, one-question-at-a-time lash intake form in Typeform's signature polished style, good for mobile-friendly client-facing intake. Logic jumps can branch questions but this is scripted branching, not an adaptive AI interview.

What it does well

  • Clean, mobile-first conversational design that's pleasant for clients to fill out
  • Strong branding/customization options typical of Typeform templates
  • Simple logic jumps can tailor question order somewhat

Where it falls short

  • No true adaptive AI follow-up questioning — branching is pre-scripted, not generated from responses
  • No voice AI interview or guided screen-share task option
  • No automated per-response quality scoring or auto-generated client report

SurveyMonkey

Lash Extension Consent Form Template

This template is scoped specifically to consent/liability language rather than a full pre-appointment intake, so it doesn't cover allergy screening, style goals, or lifestyle habits the way a full intake would. Useful as a legal-consent companion piece but narrower in purpose.

What it does well

  • Focused specifically on consent language, which is useful for liability documentation
  • Backed by SurveyMonkey's established survey distribution and response-collection tools

Where it falls short

  • Narrower scope than a full intake — no allergy/eye-health screening or style-goal capture in this template
  • Static form with no adaptive AI interview to explore client history or expectations
  • No photo-upload-plus-AI-analysis workflow or automated report generation

Ready to launch?

Open this template in the editor. Every part is yours to change before the first respondent sees it.