New Client Consultation Form

  • Facial & Massage Consultation & Consents

    *Valid 1 Year. Please complete ASAP. Existing clients only do again if changes.
  • Date of Birth:*
     - -
  •  -
  • How did you hear about GLO Beauty Bar?*

  • To Make Your Service More Enjoyable

  • Should provider wear gloves?*
  • Do you want Extractions (removal of clogged pores/blackheads)*
  • Massage Preferences (please answer even if they dont apply now, they may in the future)*
  • Swedish Massage pressure*
  • Music preference*

  • Tell Us About Your Yourself

  • Describe your skin*
  • Image field 140
  • What are your skin care challenges?*
  • Have you done the following advanced techniques/products:*
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  • Health History

    Please fill out both facial/massage portion even if just getting facial
  • Do you?*
  • Any known allergies?*
  • Health History (Face)*
  • Health History for Massage (BODY)
  • MAY need doctor's approval for Massage (if applicable). Please check all that apply:
  • Please check all that apply. These are contraindications of massage. If a massage ONLY appt is scheduled we may need to cancel or reschedule.*

  • GLO Beauty Bar, LLC CONSENTS

    1. I confirm I have disclosed all relevant health conditions, medications, allergies, and physical limitations. I understand reactions or complications, though rare, may occur and I will contact GLO and seek medical care if needed.
    2. I understand some treatments may cause temporary discomfort, bruising, visible blood vessels, minor nicks, or skin abrasions.
    3. I understand results are not guaranteed and multiple treatments may be required. Outcomes vary based on factors such as age, sun exposure, health, lifestyle, genetics, skin condition, and adherence to aftercare.
    4. I have been informed of risks, contraindications, pre/post care, and the healing process, and choose to proceed. (See: www.myglobeautybar.com)
    5. I understand any inappropriate behavior (verbal or physical) will result in immediate termination of service, full payment, and possible notification of authorities. Zero tolerance policy.
    6. I agree to immediately inform my provider if I experience pain or discomfort so adjustments can be made or the service stopped.
    7. I understand this service is not a substitute for medical diagnosis or treatment.
    8. I consent to before-and-after photos for internal records only, unless media consent is given separately.
    9. I acknowledge and agree to all GLO Beauty Bar policies regarding scheduling, cancellations, no-shows, lateness, and illness.
    10. I consent to receive occasional email and/or text communications. Message/data rates may apply. I may opt out at any time.
    11. I give permission for my provider to perform my selected service(s) and release them from liability, acknowledging all precautions will be taken.

  • MEDIA CONSENT

  • I grant GLO Beauty Bar, LLC permission to capture and use my photo, video, and/or voice. I understand that all content is the property of GLO Beauty Bar, LLC and may be edited, published, and used for advertising, educational, and marketing purposes.

    I acknowledge that I will not receive compensation for such use and release GLO Beauty Bar, LLC from any claims related to the use of this content. I understand that once published, GLO Beauty Bar, LLC cannot control unauthorized use by third parties.

    I waive any right to inspect or approve the final use of these materials.

  • Choose one*

  • CLIENT SIGNATURE

  • By signing below, I acknowledge that I have read and understood the above information, answered truthfully, and given an accurate account of my medical history.

    This Facial/Massage consent form is valid for 1 year. I agree to alert the staff if there are any future changes to my medical history.

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