Guest Registration Form

1

First Time Guests

This guest registration form is required before you will receive an appointment confirmation.

Existing Guests & Members

Please contact us at 410-456-0001 to receive your Account ID & password for our new booking system. This registration form is only required if your last consent form is older than 2022.

The contents of this form are encrypted and in HIPAA compliance.

2

Service Requested* This field is required.

Wax Service

Skincare Service

Threading Service

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Name* This field is required.

First Name

Middle Name

Last Name

4

Phone Number* This field is required.

Area Code

Phone Number

5

Email* This field is required.

example@example.com

6

At the time of my requested appointment, I will be 18 years of age or older.* This field is required.

Yes

No

7

Guests under the age of 18 must have a parent present at checkin for the first appointment. No exceptions will be made for any reason.

A Goverment issued photo ID required for the parent checking in their minor child for an appointment.

A parental consent to service form must be signed onsite prior to the appointment start.

8

Parent InformationA verification call will be made once the consent form is received.

Parent's Name

Parent's Phone Number

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Parent Section- Please Attach a Photo of Your Government Issued IDThis field is required for Identity/Age Verification. This entire form is encrypted and in HIPAA compliance.

Drag and drop files here

Select files to upload

Max. file size: 10.6MB

10

Parent Section- I agree to not enter the Premises if I am experiencing symptoms of COVID-19 such as cough, shortness of breath, or fever, have a confirmed or suspected case of COVID-19, or have come in contact in the last 14 days with a person who has been confirmed or suspected of having COVID-19. I am aware of the highly contagious nature of COVID-19 and the risk that I may be exposed to or contract COVID-19 by leaving my home and engaging in any activity on any premises. I acknowledge that I am voluntarily entering the Premises to engage in activity with knowledge of COVID-19. I hereby agree to accept and assume all risks of personal injury, illness, disability, or death related to COVID-19, arising from my being outside of my home and engaging in business on the premises, whether caused by negligence of the Business or otherwise. I hereby expressly waive and release any and all claims, now known or hereafter known, against Beauty LAB and its owners, employees, affiliates, and officers, on account of injury, illness, disability, or death arising out of or attributable to my being on the Premises or engaging in the activity and being exposed to or contracting COVID-19, whether arising out of the negligence of the Business, its owners, employees, affiliates, officers, or otherwise.* This field is required.

Yes

11

Parent Section- I hereby give consent to allow my child to receive services from Beauty LAB and do fully consent to hold harmless the minor child's service provider, Esthetician/Cosmetologist, staff, owners and anyone affiliated with Beauty LAB from any liability that may result from this treatment.

Yes- I consent

12

Parent Section- I do not hold Beauty LAB or the service provider, who performs services for my minor child, responsible for any conditions that were not present or present, but not disclosed at the time of this procedure, which may be affected by the treatment performed at the requested appointment.

Yes- I consent

13

Parent Section- I agree that this constitutes full disclosure, and that it supersedes any previous verbal or written disclosures. I certify that I have read, and fully understand the above paragraphs and that I have had sufficient opportunity to contact Beauty LAB to have any questions answered. I understand the procedure and accept the risks on behalf of my minor child.

Yes- I consent

14

Note: Your signature submitted on next screen must be legible.

Scribbled signatures will not be accepted and this entire form will need to be resubmitted if your signature is rejected.

15

Parent Section - Signature

Clear

16

Thank you for your consent to service. The minor child may complete and submit the form.

Let’s go over some medical information

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Are you currently using or taking: Alpha-Hydroxy or Glycolic Acids* This field is required.

YESNO

19

Please List:

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If yes, when and where are you using Alpha-Hydroxy or Glycolic Acids?* This field is required.

21

Are you currently using or taking: Retin-a, Renova, Accutane* This field is required.

YESNO

22

Specify which product Retin-a, Renova, Accutane and how it is being used:* This field is required.

23

We are unable to provide wax services to guests who are using: oral Accutane.

Please call the studio if you have any questions.

24

Are you currently using or taking: Any other blood/skin thinning products/drugs* This field is required.

YESNO

25

We are unable to provide services to guests who are using: blood/skin thinning products/drugs.

Please call the studio if you have any questions.

26

Are you currently using: Tanning Bed* This field is required.

YESNO

27

Do you have Herpes Virus, Staph/MRSA, or Allergies:* This field is required.

Herpes Virus

Staph/MRSA

Allegies

None

28

Do you have: Herpes Virus* This field is required.

YESNO

29

We are unable to provide services to guests who have a visible Herpes Virus outbreak.

Please call the studio if you have any questions.

30

Do you have: Staph/MRSA* This field is required.

YESNO

31

Do you have: Allergies* This field is required.

YESNO

32

If so, please list Allergies* This field is required.

33

Have you been tested for Covid-19?* This field is required.

YESNO

34

Do you have: Covid-19 or any Covid-19 symptoms* This field is required.

YESNO

35

I agree to not enter the Premises if I am experiencing symptoms of COVID-19 such as cough, shortness of breath, or fever, have a confirmed or suspected case of COVID-19, or have come in contact in the last 14 days with a person who has been confirmed or suspected of having COVID-19. I am aware of the highly contagious nature of COVID-19 and the risk that I may be exposed to or contract COVID-19 by leaving my home and engaging in any activity on any premises. I acknowledge that I am voluntarily entering the Premises to engage in activity with knowledge of COVID-19. I hereby agree to accept and assume all risks of personal injury, illness, disability, or death related to COVID-19, arising from my being outside of my home and engaging in business on the premises, whether caused by negligence of the Business or otherwise. I hereby expressly waive and release any and all claims, now known or hereafter known, against Beauty LAB and its owners, employees, affiliates, and officers, on account of injury, illness, disability, or death arising out of or attributable to my being on the Premises or engaging in the Activity and being exposed to or contracting COVID-19, whether arising out of the negligence of the Business, its owners, employees, affiliates, officers, or otherwise.* This field is required.(YES)

YESNO

36

Consent to service: I give permission to my licensed professional to perform the procedure I have requested and will hold Beauty LAB and their staff harmless from any liability that may result from this treatment. I have given an accurate account of the questions asked above including all known allergies or prescription drugs or products I am currently ingesting or using topically.* This field is required.(YES)

YESNO

37

Consent to service: I agree that this constitutes full disclosure, and that it supersedes any previous verbal or written disclosures. I certify that I have read, and fully understand the above paragraphs and that I have had sufficient opportunity for discussion to have any questions answered. I understand the procedure and accept the risks.* This field is required.(YES)

YESNO

38

Consent to service: I understand that if I change my skin care routine or medications I must inform Beauty LAB prior to any service in the future.* This field is required.(YES)

YESNO

39

Consent to service: I do not hold Beauty LAB or the licensed professional, who performs my services, responsible for any of my conditions that were not present or present, but not disclosed at the time of this skin care procedure, which may be affected by the treatment performed today.* This field is required.(YES)

YESNO

40

I agree to not enter the Premises if I am experiencing symptoms of COVID-19 such as cough, shortness of breath, or fever, have a confirmed or suspected case of COVID-19, or have come in contact in the last 14 days with a person who has been confirmed or suspected of having COVID-19. I am aware of the highly contagious nature of COVID-19 and the risk that I may be exposed to or contract COVID-19 by leaving my home and engaging in any activity on any premises. I acknowledge that I am voluntarily entering the Premises to engage in activity with knowledge of COVID-19. I hereby agree to accept and assume all risks of personal injury, illness, disability, or death related to COVID-19, arising from my being outside of my home and engaging in business on the premises, whether caused by negligence of the Business or otherwise. I hereby expressly waive and release any and all claims, now known or hereafter known, against Beauty LAB and its owners, employees, affiliates, and officers, on account of injury, illness, disability, or death arising out of or attributable to my being on the Premises or engaging in the Activity and being exposed to or contracting COVID-19, whether arising out of the negligence of the Business, its owners, employees, affiliates, officers, or otherwise.* This field is required.

Yes

41

Consent to service: I give permission to my licensed professional to perform the procedure I have requested and will hold Beauty LAB and their staff harmless from any liability that may result from this treatment. I have given an accurate account of the questions asked above including all known allergies or prescription drugs or products I am currently ingesting or using topically.* This field is required.

Yes

42

Consent to service: I give permission to my licensed professional to perform the procedure I have requested and will hold Beauty LAB and their staff harmless from any liability that may result from this treatment. I have given an accurate account of the questions asked above including all known allergies or prescription drugs or products I am currently ingesting or using topically. I agree that this constitutes full disclosure, and that it supersedes any previous verbal or written disclosures. I certify that I have read, and fully understand the above paragraphs and that I have had sufficient opportunity for discussion to have any questions answered. I understand the procedure and accept the risks. I do not hold Beauty LAB or the licensed professional, who performs my services, responsible for any of my conditions that were not present or present, but not disclosed at the time of the scheduled procedure, which may be affected by the treatment performed today. I understand that if I change my skin care routine or medications I must inform Beauty LAB prior to any service in the future.* This field is required.

Yes

43

Consent to service: I agree that this constitutes full disclosure, and that it supersedes any previous verbal or written disclosures. I certify that I have read, and fully understand the above paragraphs and that I have had sufficient opportunity for discussion to have any questions answered. I understand the procedure and accept the risks.* This field is required.

Yes

44

Consent to service: I do not hold Beauty LAB or the licensed professional, who performs my services, responsible for any of my conditions that were not present or present, but not disclosed at the time of the scheduled procedure, which may be affected by the treatment performed today.* This field is required.

Yes

45

Consent to service: I understand that if I change my skin care routine or medications I must inform Beauty LAB prior to any service in the future.* This field is required.

Yes

46

This is my first time visiting Beauty LAB.* This field is required.

YESNO

47

Things To Remember

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Service Review - 24 hour notice is required to make changes to your appointment. Please call us at the studio as we may be unable to add or remove services during the check-in of your appointment.* This field is required.

I Understand

49

Please arrive by the start time of your appointment to check in with the front desk, as we do not have a late arrival grace period, per our policies. If you are not checked in with the front desk by the appointment start time, your appointment time may be given to the next available guest or your service may be reassigned to a different specialist, if not, cancelled. Appointments cancelled same day will incur a minimum fee of 50% of the service total.* This field is required.

I Agree

50

Please do not bring anyone who does not have an appointment to your appointment as they will not be allowed to enter the building. A parent of a minor guest may remain the waiting area during the service. Anyone under the age of 18 is not permitted in the studio unless they have an appointment. If you bring a minor child to your appointment, the appointment will be cancelled and a same day cancellation minimum fee of 50% of the service total will be incurred.* This field is required.

I Agree

51

I have read and agree to all of the Beauty LAB Policies.* This field is required.

I Agree

52

We look forward to seeing you.

Please give us a call at (410) 456-0001 if you have any questions.

Frequently Asked Questions

53

Please Attach a Photo of Your Government Issued ID* This field is required.This field is required for Identity/Age Verification. This entire form is encrypted and in HIPAA compliance.

Drag and drop files here

Select files to upload

Max. file size: 10.6MB

54

Note: Your signature submitted on next screen must be legible.

Scribbled signatures will not be accepted and this entire form will need to be resubmitted if your signature is rejected.

55

Signature* This field is required.

Clear