• Body Scuplting

    Body Scuplting

    Client Intake Consent
  • Gender*
  • Date of Birth*
     - -
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • How did you hear about Krown Mee Beauty?*
  • Do you have any of the following conditions? If yes, please select them:*
  • Are you pregnant or breastfeeding?*
  • Are you taking any contraceptive pills?
  • Have you undergo any surgeries?*
  • Do you consume alcohol?
  • Do you consume caffeinated drinks?
  • Are you currently active physically (exercise)?
  • Are you currently under any kind of diet?

  • Terms & Conditions

  • I understand that my data will be strictly confidential. This clinic does not sell, share, or resell information. 

    I consent to the taking of photographs/video for documentation during my treatment(s) unless otherwise stated with written notice to Krown Mee Beauty. These photos may be used for marketing and/or publication for the further benefit of educating the public. All attempts will be made to protect my identity.

    I confirm that all information in this form is true and accurate.

    I confirm that if I hold some important information and complications happened, the clinic will not be liable.

    I release this clinic and hold harmless against any claims, expenses, damages, and liabilities.

    I understand and accept that there is a 24-hour notice for cancellation/rescheduling and a 20min grace period for lateness. "NO SHOW" for appointments WILL result in a $50 service charge deductible from prepaid service package. Remaining balance will be applied towards my next service appointment with regards to TIME LIMITS.

    **Services, Specials, Flash Sales & Promotions MUST BE completed within 30 days of purchase date. There is no refund or returns policy. All sales are final!**

  • By typing and signing my name I attest that I accept the policy and terms

     *   *   

  • Date Signed*
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  • Should be Empty: