• Facial Consent Form

    Sunshine Glow Spa
  • Date*
     / /
  • How did you hear about us?*

  • Your Medical History

  • Have you experiences any of these health conditions in the past or present?

  • For the Ladies...
  • Any known allergies?

  • Are you taking any of these Medications topical or oral?
  • Have you received/use any botox/fillers/injectables OR Retinol/retinol creams in the 7 days*

  • Tell us about your skin

  • Do you wear SPF everyday?
  • What skin care products are you currently using?*
  • What skincare brands do you use at home? (you can chose more then 1)*

  • Have you been diagnosed with eczema, psoriasis or rosacea?
  • Have you received any of these facial hair removal services on your face in the last 7 days?
  • Do you?
  • Do you consent SunshineGlowSpa to take Photos/Videos during the service for before and After to be posted on SocialMedia/Website for Educational and Marketing Purposes?*

  •  Friendly reminders for your appt. 

     

    1.Please do not wear make-up to your facial appt. (Prefer. Not required)

     

    2.Please STOP USING retinol 3 days before and after your appt. 

     

    3.Please wait 2 weeks after botox/filler before receiving a facial. 

     

    4.Please bring cash if you desire to leave a tip (Prefer not required/cards are accepted)

     

    5. And last Remember to relax and enjoy your service. 

  • I acknowledge that my skin might experience temporary irritation, tightness, redness or slight swelling which usually dissipates within 72 hours depending on skin sensitivity.  I acknowledge that if I am allergic to one or more ingredients in the products used, I may experience allergic reactions. I acknowledge that if I fail to use a minimal sunscreen (SPF 30+), I am more susceptible to sunburn, skin damage & hyperpigmentation.  I acknowledge that this treatment is strictly elective cosmetic procedure and no medical claims have been expressed or implied. I acknowledge that I should avoid the use of Retin-A type products, aggressive exfoliation, waxing, and products containing acids that are no part of the recommended take-home regimen for 2-4 weeks following treatment. I consent (to the best of my knowledge) that the answers I have given are correct and that I have not withheld any information that may be relevant to my treatment. I give consent for all future treatments I release Sunshine Glow Spa and its staff of any liability associated with any injuries and /or current and future conditions resulting from the skincare procedures or products.

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