Consent Forms
LETS SCULPT YOU GODDESS
Name
First Name
Last Name
Date of Birth
-
Month
-
Day
Year
Date
Email
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
I acknowledge that:
I understand that Body Contouring benefits in terms of shaping the body with the use of infrared sauna, laser lipo, ultrasound cavitation, radio frequency, whole body vibration therapy, vacuum therapy, or wood therapy.
I have been briefed on the potential risks and side effects of Body Sculpting, which may include but are not limited to redness, swelling, heat sensitivity, itchiness, increased bowel movements, and increased urination.
I understand that Body Contouring is not a treatment for any medical condition, nor used to relieve symptoms of any medical condition.
I understand that this is a strictly voluntary cosmetic procedure. No treatment is necessary or required and the Body Sculpting Therapy has been chosen by myself.
I Authorization Travel Goddess Bodies to Release of Photos or Videos on its Social Media Platforms?
Yes
No
I Also Acknowledge
*
That women during menstruation or with fever are not allowed to have treatment. As such, appointments can be rearranged on a later schedule.
I recognize that I lack the following conditions, and if I have any of them, I am unable to proceed with obtaining the following services: lymphatic disorder, pregnancy or breastfeeding, acute illness, high blood pressure, cancer/undergoing chemotherapy, thyroid condition, skin disease, diabetes.
I do have 1 or more
I don’t have any of the above conditions.
You do understand that Travel Goddess Bodies operates under a 24-hour cancellation and rescheduling policy. Any cancellations or changes made within 24 hours of the scheduled appointment will result in the forfeiture of the deposit. For same-day appointments that are rescheduled or canceled, a fee of 50% of the service cost, in addition to the deposit, will be charged. To avoid these fees, clients are kindly requested to reschedule or cancel their appointments within 48 to 24 hours prior to the scheduled time, as communicated in the confirmation. Failure to attend the appointment without prior notice will result in a no-show fee equal to the full value of the appointment.
Yes
No
Date Signed
-
Month
-
Day
Year
Date
Signature
Please upload the front of your license for verification purposes.
Submit
Submit
Should be Empty: