Spray Tanning Consent Form
  • Spray Tanning Consent Form

  • Format: (000) 000-0000.
  • Date of Birth
     - -
  • Gender
  • Is this your first spray tan?
  • What is your skin type?
  • Do you have any allergies specifically related to Dihydroxyacetone (DHA)?
  • Are you pregnant or breastfeeding?
  • Are you currently taking any medications?
  • Consent Agreement

  • Please read, understand, and sign the following:

    DHA is listed by the Food, Drug, and Cosmetic Act (FD&C Act) as a color additive for use in imparting color to the human body. However, its use in costmetics - including "sunless tanning products" - is restricted to external application. According to CFR, "externally applied" cosmetics are those applied only to "external parts of the body and not to the lips or any other parts of the body covered by mucous membrane". 

     

    • DHA reacts with the skin's amino acids resulting in a "tan" similar looking to that achieved with sun exposure. The darker you can tan naturally, the darker you can tan with a spray tan. Like most cosmetics, avoid exposure to the eyes, lips, and other parts of your body covered with mucous membranes. This can be accomplished by wearing protective eyewear and clothing, applying a barrier cream. Avoiding inhalation can be accomplished with adequate air filtering using a filtered extraction fan during application. 

     

    • Your spray tan should last 5-10 days, depending on your skin type and how well your take care of your spray tan. It is very important to  keep your skin moisturized and avoid chlorinated swimming pools. Please visit our website at NomadicTans.com to see a full list of best practices recommended. 

     

    • Be advised there may be a small percentage of individuals that may not react favorably to spray tanning. Some medications such as birth control pills, hormone replacement therapy, or antibiotics may alter your tan. Please consult with your technician if you have any questions. 

     

    • Some fabrics may be stained by spray tanning solution prior to your first shower. Please be cautious as to what you wear, sit on, lean against, and otherwise allow to touch your skin PRIOR to your first shower. 

     

    • All ingredients in the products used are intended for cosmetic use and are generally regarded as safe. There are, however, occasions where individuals may be allergic to one or more ingredients in the spray tan solution. If this happens, shower and discontinue use. If severe reaction, contact your physician. You may ask to see the ingriedient list prior to your application. 

     

    • Be advised, we do NOT recommend being spray tanned for imporant events such as weddings, photo sessions, modeling assignments, etc. without doing a TRIAL TAN to ensure your skin reacts favorable to the spray tan.

    WARNING - This product does NOT contain sunscreen and does not provide any protection from the sun's UV rays. 

     

    I have read the content of this consent form carefully and state that I am not aware of any medical condition, allergies, or other reason that would prohibit me from sunless tanning. I have been given adequate instructions for the proper use of the sunless application, understand the risks involved, and use it at my own risk. I hereby agree to release the owner, operator, and manufacturers from any legal liability or dangers that I might incur due to the use of the facility. I have been advised to discontinue use if any reaction occurs. 

     

    I have read and completely undersand this form.  

  • Date Signed
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  • Date Signed
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  • Date Signed
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  • Should be Empty: