New Client Consultation Form
Date
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Month
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Day
Year
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Name
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First Name
Last Name
Gender
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Female
Male
Address
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Street Address
Street Address (2)
City
State / Province
Postal / Zip Code
Mobile Number
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Area Code
Phone Number
How did you hear about me?
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Website / Online Search
Google
Yelp
Instagram
Facebook
Referral
Kenoshaweddings.com
Other
E-mail
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If Referral, please list name
If Other, please let me know
Your Skin
Have you had a spray tan before?
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Yes
No
Any issues with a previous spray tan? (i.e. areas that didn't take color very well, patchiness, dark spots, coverage issues)
What is your skin type?
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Type I - Typically VERY LIGHT or PALE WHITE - Always burns, never tans - must use 50+ SPF sunscreen throughout summer season
Type 2 - Typically WHITE or FAIR - Usually burns at first but develops a tan by the end of the summer - must use 30+ SPF sunscreen at the beginning of summer or for prolonged exposure
Type 3 - MEDIUM WHITE, OLIVE or TAN - Rarely burns unless prolonged exposure and then tans well. May use 15+ SPF at the beginning of summer
What is your skin tone?
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COOL - pink, red or bluish undertones (Looks good in blue, lavender, rose and grey colors)
WARM - yellow, peachy or golden undertones (Looks good in olive, coral, honey and cream colors)
What is your skin condition? (check any that apply)
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Oily
Dry
Normal
Sensitive
Acne Prone
How often do you typically use moisturizer on your skin?
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Never
Only when you feel really dry
1-2 times per week
Daily
Winter only
Any age or sun spots?
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Yes
No
Do you have any allergies?
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Yes
No
If so, please list what you're allergic to.
PLEASE NOTE: If you use or have used Retin-A, Renova, Adapalene, Accutane, Differen, Glycolic Acid, Lactic Acid, Mandelic Acid, Retinol, or other Vitamin A derivitives, IT MAY NEGATIVELY AFFECT YOUR SPRAY TAN RESULTS
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Yes, currently using
Yes, but not within the last 30 days
Yes, but not within the last 6 months
No
Have you had a sunburn in the last 6 months? PLEASE NOTE: Spraying over a sunburn (even an old sunburn that is no longer visible to they eye) MAY RESULT IN UNEVENESS, PATCHINESS AND PEELING
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Yes
No
Severity?
MILD (slightly pink skin but no peeling)
MODERATE (pink or red skin with mild peeling)
SEVERE (very red skin and heavy peeling)
Do you have any skin conditions or disorders?
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Yes
No
If so, please list
Any known allergies to these items?
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Tree Nuts
Latex
Fragrances / Essential Oils
None
Have you used or been prescribed any medications (topical or oral) for acne / acne control? PLEASE NOTE: THE USE OF ACNE PRODUCTS MAY NEGATIVELY AFFECT YOUR SPRAY TAN RESULTS
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Yes
No
Acknowledgement
Your commitment to achieving flawless spray tan results:
Please read and check EACH box:
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I understand that I must follow the Spray Tan PREP & AFTERCARE instructions that were provided to me.
I will shave & exfoliate thoroughly 24 hours PRIOR to my appointment, NOT the day of. This also applies to treatments for waxing, mani/pedi, lash extensions & microblading.
I will avoid using exfoliating sugar or salt scrubs as these products may contain oils that will create a barrier if used the day before.
I WILL NOT use any Dove soap or lotion products as they will leave a film my skin which will negatively affect my application and overall results.
I will avoid using razors with a "moisture strip" as they may cause streaking in my final result.
I will arrive at my appointment with skin that is is clean, dry and free of all products including makeup, deodorant, lotions, moisturizers, acne treatments, powder, essential oils, perfumes or sprays.
I understand that my spray tan will have less than optimal results if I've had a sunburn within the last 6 months.
I understand that I will inform my spray tan technician if I am pregnant or breastfeeding before my appointments.
I will inform my spray tan technician if I have any open cuts or wounds prior to my appointments.
Signature
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