New Client Consultation Form

New Client Consultation Form
Date *

Month Day Year
Name *

First Name Last Name
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Mobile Number *

Area Code Phone Number
E-mail *
How did you hear about me? *

Website / Online Search Google Yelp Instagram Facebook Referral Other
If Referral, please list name
If Other, please let me know
Your Skin
What is your skin type? *

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? *

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) *

Oily Dry Normal Sensitive Acne Prone
Have you had a spray tan before? *

Yes No
Any issues with a previous spray tan? (i.e. areas that didn't take color very well, patchiness, dark spots, coverage issues)
Any age or sun spots? *

Yes No
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 *

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 *

Yes No
Do you have any skin conditions or disorders? *

Yes No
If so, please list
Any known allergies to these items? *

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 *

Yes No
Acknowledgement

Your commitment to achieving flawless spray tan results:
Please read and check EACH box: *

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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New Client Consultation Form

Your Skin

Acknowledgement