Makeup Services Consent
Today’s Date
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Month
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Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Name
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First Name
Last Name
Email
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example@example.com
Address (please include your apt number)
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Street Address
Apartment Number
City
State / Province
Postal / Zip Code
Phone Number
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Area Code
Phone Number
Birthday
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Month
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Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Please tell me how you were referred to me.
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Which service are you booking today?
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Makeup Application
Makeup & Hair Styling
Makeup Trial (Bride)
Makeup Lesson
Makeup Lesson w Shopping
Please tell me more about your event /needs for beauty services
What date(s) will you need services?
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What time do you need to be done?
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Will you need me to travel to you? Please include the address.
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How many people need makeup/ hair? Please list their names, relation to you. For hair, please note if they will need a waves, blow-out or updo. For makeup please indicate the preferred style.
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If you have had your makeup done in the past or a makeup lesson, what did you LOVE about it and what could you live without?
If you could wave a magic wand, what style of makeup would you like to leave with- or learn about (if this is a lesson).
Medical, Health, Bodily Conditions: Is there anything I need to know before we get started? The more I know, the better your results. Please List: allergies, sensitivities. Health issues such as epilepsy, active cold sores, facial herpes. Topical products that might cause skin sensitivity. Waxing or laser in the past week or injectables. Medications and use of Accutane or other acne medications. Do you have any skin allergies or sensitivities to makeup, skincare products or ingredients?
Anything else you want to share? I love learning about my clients as it helps me provide superior customer service.
Consent for Services
Please read carefully and click the checkbox to acknowledge
I hereby consent to and authorize Daniella Shachter dba Makeupwithdani LLC/ The Chill Facialist, who from here on will be referred to as "Makeupwithdani" to perform makeup application and beautifying services. Although it is impossible to list every potential risk and complication, I am aware of possible risks and complications that can occur during makeup, skincare and brow shaping services. I have also, to the best of my knowledge, given an accurate account of my medical history, including all known allergies or prescription drugs or products I am currently ingesting or using topically that could affect makeup or skincare. I understand the service(s) and accept the risks. All of my questions have been answered to my satisfaction and I consent to the terms of this agreement. I do not hold Makeupwithdani responsible for any of my conditions that were present which may be affected by the treatment or makeup application performed today or any condition that may arrise afterwards.I hereby release and agree to hold Makeupwithdani harmless from, and waive on behalf of myself, my heirs, and any personal representatives any and all causes of action, claims, demands, damages, costs, expenses and compensation for damage or loss to myself and/or property that may be caused by any act, or failure to act or that may otherwise arise in any way in connection with any services received from Makeupwithdani. I understand that this release discharges Makeupwithdani from any liability or claim that I, my heirs, or any personal representatives may have with respect to any bodily injury, illness, death, medical treatment, or property damage that may arise from, or in connection to, any services received from Makeupwithdani. This liability waiver and release extends to in studio or on location together with all owners, partners, and employees.
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I Agree
I understand The Chill Facialist /Makeupwithdani might require a 50% deposit to confirm your date. The Chill Facialist /Makeupwithdani has a strict 24 hour cancellation policy. In the event of a late cancellation/no show the fee is 100% of the cost of service. Your card on file will be charged. If I am able to replace your appointment with a client on the wait list I will be happy to waive fee.
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Yes
Name or parent/ guardian if under 18
Submit
Your Signature or Signature of parent or guardian if under 18
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Should be Empty: