Consent of Services & Treatment

Consent of Services & Treatment
Name*

First NameLast Name
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Email*
example@example.com
Date*

MonthDayYear
Date
Have you had any changes in your medical history since your last visit? **if yes please re-fill out the Consult form***

NoYes
What services are you receiving today?*

WaxingLash LiftBrow LaminationLash TintBrow TintSkin TreatmentLash Extensions
Disclaimers and Liability disclosure

Receiving a service from a Chadoux Beauty is an at will service. Chadoux Beauty will never force, coerce, or intimate anyone into receiving a service. Chadoux Beauty will conduct consultations to ensure that any treatment given is safe for the guest to the best of their abilities. Chadoux Beauty cannot and will not be held responsible for any reactions that happen due to dishonesty on the intake form, or for reactions caused by natural circumstances that are not due to negligence. Chadoux Beauty has the right to refuse service from anyone at any time for any reason.

By signing this form you are acknowledging that you have read this from and have provided the most accurate answers to the screening questions. You have released Chadoux Beauty, and its subsidiaries from any liabilities from any treatments received on signed dates below. You understand that Chadoux Beauty and its subsidiaries will provide the best service to their abilities, and will not cause intentional harm. You understand that there are potential side effects with any treatment received and that Chadoux beauty and its subsidiaries will go over that information with me.
Treatment of Minors;

Chadoux Beauty will provide services for minors (persons under 18 years of age). Minors must be accompanied by an adult guardian during the treatment.
Have you read and understood the Disclaimers and Liability disclosures, and the Treatment of minors?*
Signature*
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