Pedicure/Manicure/Nails Consent Form

Client's Name

First NameLast Name

Email

example@example.com

Phone Number

Please enter a valid phone number.

Services you would like

ManicureNail extensionPedicureMedical-Grade Pedicure/Manicure

Current Health Conditions: (Please select below)

Do you have any allergies? Latex allergy?

YesNo

Please list below the type of allergies that you have

Have you undergo any surgical procedure?

YesNo

Please list the name of the procedure and the reason

Are you currently taking any medications?

YesNo

Please list them below including vitamins and supplements

What are your Nails/Feet Expectation?

Are you wearing gloves if you clean the house, do the gardening, or washing dishes?

YesNo

How do you take care of your hands?

How do you take care of your feet?

Are you currently using or applying products to your hand/feet ? If yes, please list the name of the products below

When is the last time you had a professional nail/manicure/pedicure service?

How often do you get a pedicure/manicure ?

Nail condition

Feet condition

Do you have any cuts or wounds in your hands or feet?

YesNo

Are you preparing for a special occasion?

YesNo

Would you like to receive promotions and offers via email?

YesNo

I have read the above information and I have given an accurate accontant of the questions. If I have any concerns, I will address these with my technician before the service begins. I give premission to my technician to perform the hair services we have disccussed and will not hold the technician nor Timeless Salon and Spa accoutable for any liability that may result from this treatment. I unserstand that my technician will take every precaution to minimize or eliminate negative reactions in every way possible

Consent to Treament of Minor: By siging below. I hereby authozied Timeless Salon and Spa to administer Pedicure, manicure and nails services, chemical services, skicare, make up and or/waxing services to my child or dependent.

Reservation & Cancellation Policy for all appointments: Charging a Cancelation fee is probably the least part of running our service. However, it is necessary to ensure we can remian open to serve you. A a credit card on File is required for all appointments.

We have implemented a policy which enables you to maintain your credit card information securely on file with Timeless Salon and Spa. In providing us with your credit card information, you are giving Timeless Salon and Spa permission to automatically charge your credit card on file for no-show appointments, appointments not amended with 24 hours of initial reservation, outstanding balances, services, and/or products. Fees for services rendered are due at the time of your appointment in the Spa. No-show fees and reservations amended without 24 (twenty-four) hour notice will be charged within 2 (two) business days of the initial reservation.

You may still choose to make your payment for in studio services by cash or a card different from the credit card on file. A copy of the charge will be given or emailed to you.

The card holder may also revoke this consent at any time in writing while understanding that continued services may not be available if a credit card is not on file.

Here at Timeless Salon & Spa we understand that accidents and emergencies happen that prevent 24-hour notice for canceling or rescheduling your appointment. Salon/Spa Loyal Clients are given one (1) grace appointment per year for last-minute scheduling changes, cancellations, or no-shows. Please contact us on how to sign up for free today!

I confirm that all information given in this form is true, complete, and accurate.
I hereby authorize Timeless Salon and Spa to maintain my credit card on file for services rendered, no-show appointments (100% reserved service amount), appointments not amended within 24 hours (50% reserved service amount), outstanding balances, and/or products. Appointment booked within 24h must reschedule or cancel within 4 hour of the appointment time or will result in a charge equal to 50% if the reserved service amount

I released this organization for any responsibility in case of accident, illness, or injury.

I acknowledge that no assurance was offered about the outcome.

I understand the reservation and cancellation policies at Timeless Salon and Spa and Agreed to this Policy.

I understand there is no return or refund on service or product has been used.

I agreed to give Timeless Salon and Spa the right to use the photos of my service result for marketing purposes.

Client Signature

Date Signed

Date

Pedicure/Manicure/Nails Consent Form

Health History

Nail Care Questions