• Clover Beauty LLC

    General Consent Form
  • Birthday*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Format: (000) 000-0000.
  • Are you pregnant, breastfeeding, or planning on becoming pregnant?*
  • Please check all that apply to you*
  • What are your skin concerns?

  • Photo Consent

    Clover Beauty LLC may use photos for marketing on websites, printed marketing, or social media posts. These photographs are used to represent and promote Clover Beauty services. Your identity will remain confidential. You may opt out of photo consent if you wish.
  • Do you consent to Clover Beauty taking and using photographs for marketing or social media purposes?*
  • I hereby grant permission to Clover Beauty LLC to take photos to use for any confidential charting purposes and allow Clover Beauty to use said photos for marketing and social media posts. I have read and agree to all terms stated above.*

  • Treatment Consent

  • By signing this form, I acknowledge that I am aware of the risks involved and give consent to receive skin care, waxing, and lash services from my esthetician/Clover Beauty LLC. I understand that this agreement is binding and will remain in effect for all immediate and future services/procedures received at Clover Beauty LLC. I certify that I have read and understand this entire consent form and I agree to the information provided in this form. I certify that I am at least 18 years of age and give my consent to treatment, or I have parental consent co-signed below. The treatments I receive here are voluntary and I release Clover Beauty LLC and/or the esthetician from liability and assume full responsibility thereof. I understand that my esthetician has the right to refuse services if a client arrives ill or the service is not optimal for their concerns/skin health. This is to protect the client and esthetician in question.

    Furthermore, last minute cancellations with less than 24 hrs notice will be subject to a 30% fee. A no call, no show will be subject to a fee of the full service amount. I agree to adhere to these policies in order to respect both my esthetician's time as well as the time of other potential clients. 

  • I have read and understand the cancellation and no show policy, and agree to follow it*
  • Is this treatment for a minor?*
  • Date*
     - -
    2 digit month, 2 digit day, 4 digit year

  • Treatment on a Minor

    Please initial to indicate your acknowledgment

  • By signing this form, I understand and agree to everything above, and in addition: I verify that the minor client is of sufficient age and aptitude as to provide verbal feedback to the esthetician before, during, and after the treatment. I also understand that I am welcome and encouraged to remain in the treatment room or area during the enitre length of the appointment.

  • Date*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Date*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Should be Empty: