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  • 10 What skin care products are you currently using? List brand where known

  • 12 What areas of concern do you have regarding your: Skin: (Please check any that apply and explain)

  • Female Clients Only

  • Male Clients Only: 

  • Future Appointments/Contact

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    I understand, have read and completed this questionnaire truthfully. I agree that this constitutes full disclosure, and that it supersedes any previous verbal or written disclosures. I understand that withholding information or providing misinformation may result in contraindications and/or irritation to the skin from treatments received. The treatments I receive here are voluntary and I release TheMantra Beauty from liability and assume full responsibility thereof.

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  • Guest Photo/Media Release

  • This form seeks for the consent for photographs to be taken by the TheMantra Beauty through a therapist or a representative.

    By signing this form, I affirm in understanding that the images may be used for different purposes including but not limited to;

    • Educational purposes such as treatment procedure demonstration
    • Social media and online publishing ads
    • Print marketing advertisements
    • Video and television media advertisements

    By consenting to the release of images/videos, you agree that you will not receive any form of compensation.

     

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