Facial Treatment Consent Form
Client Information
Full Name
Date of Birth
Phone
Email
Medical History
Do you have any of the following (please check all that apply):
Allergies
Skin Conditions
Heart Conditions
Pregnancy
Other
Current Medications:
Have you had any previous facial treatments?
Consent
I acknowledge and understand the following:
I have answered all questions truthfully.
I understand the possible risks and side effects.
I consent to receiving the facial treatment.
Questions/Concerns:
Client Signature
Date