New Client Form (Required)

  • Client Consent & Questionnaire Form

    Please fill form COMPLETELY before booking an appointment.
  • Format: (000) 000-0000.

  • General Questionnaire

    Please fill the questions below accordingly.
  • Are you currently taking any medications? If so, please consult with your artist.*
  • Are you planning a pregnancy, pregnant, or nursing?*
  • Are you currently using any Alpha Hydroxy Acid (AHA), Glycolic Acid, or Salicylic Acid products?*
  • Are you currently using topical retinol such as Retin-A, Tretinoin or Renova?*
  • Have you ever experienced a skin irritation, rash, or acne?*
  • Have you ever had a reaction to medicine, food, clothing, flowers, cosmetics, hair dye, perfumes, or jewelry?*
  • Do you consider yourself to have sensitive skin or eyes?*

  • If YES to any of the above, these treatments need to be stopped AT LEAST 3-7 days before your Brow or Facial Service. The earlier these treatments are stopped, the better the service.

  • Are you using any other skin thinning products and/or medications (Accutane, blood thinners, antibiotics, etc)?**

  • If yes to the above, you must wait at least 4 weeks after your medication is completed prior to any brow services. NO EXCEPTIONS !

  • Do you wear contacts?*
  • Do you have any allergies ?*

  • Facial Q&A

    Please note, all information should be filled out accurately or session will NOT be booked. No exceptions.
  • Have you had a facial before ?*
  • Have you had any facial treatments/seen by a dermatologist/using any chemicals ?*
  • Medical History

  • Brow Q&A

    Please note, all information should be filled out accurately or session will NOT be booked. No exceptions.
  • Brow Services
  • Have you ever had your brows Tinting/Henna/Stain/Hybrid/Lamination /PMU ?*
  • Do you have allergies to any ingredients in hair dyes and/or perming products?*
  • Have you experienced an allergic reaction after any brow service ?*
  • Have you experienced an allergic reaction after any brow WAX service ?*

  • Photograph & Video Release Consent

    Be Advised, I MAY OR MAY NOT USE THE CONTENT. This is just in case clips may be used from the service.
  • I hereby grant permission to the rights of my image, likeness and sound of my voice as recorded on audio or video tape without payment or any other consideration. I understand that my image may be edited, copied, exhibited, published or distributed and waive the right to inspect or approve the finished product wherein my likeness appears. Additionally, I waive any right to royalties or other compensation arising or related to the use of my image or recording. I also understand that this material may be used in diverse educational settings within an unrestricted geographic area.

  • Consent & Liability

  • Although every precaution will be made taken by Chiese M. to ensure your safety and wellbeing before, during and after your tinting application, please be aware of the possible risks below:

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    ALLURED AESTHETICS – COMPREHENSIVE CLIENT CONSENT & LIABILITY RELEASE

     By completing and submitting this form, I acknowledge and agree to the following for all services offered by Allured Aesthetics (including brows, skin treatments, and body contouring):

     
    1. General Consent & Understanding

    I confirm that all information provided above is accurate and complete to the best of my knowledge. I understand that it is my responsibility to disclose any health conditions, medications, skin sensitivities, allergies, or any other factors that may affect my treatment. I will inform the technician of any changes in my health status before each treatment.


    2. Skin‑Related Services (Facials, Chemical Peels, Dermaplane, Microneedling, Enzymes, Advanced Skincare)

    I understand that skin treatments may involve procedures that remove dead skin, resurface layers of the skin, exfoliate, or otherwise modify appearance. I understand these treatments do not guarantee specific outcomes, and I may have temporary side effects such as redness, irritation, sensitivity, peeling, swelling, or pigmentation changes. I agree to follow pre‑ and post‑care instructions provided by Allured Aesthetics.


    3. Brow & Lash Services (Waxing, Tinting, Lamination, PMU, Lash Extensions & Lifts)

    I understand that brows and lash services involve the use of dyes, tints, chemical solutions, heat, or mechanical techniques. I acknowledge there is a risk of irritation, allergic reaction, incomplete uptake, or less‑than‑desired results. Permanent makeup procedures involve pigment placement and healing variability; results may fade over time and require touch‑ups.


    4. Body Contouring (RF, Cavitation, Vacuum, EMS or Similar Technologies)

    I understand that body contouring services at Allured Aesthetics are cosmetic in nature and designed to improve appearance only. These treatments use machine‑assisted energies (such as ultrasound, radiofrequency, suction, and electrical muscle stimulation). I acknowledge results vary by individual and are not guaranteed. I confirm I do not have any contraindications (e.g., pregnancy, pacemaker, severe medical conditions, or other restrictions advised by the technician), and that these have been disclosed.


    5. Risks & No Guarantees

    I understand that cosmetic, skin, and body treatments may involve potential side effects, including but not limited to temporary redness, swelling, bruising, tenderness, irritation, scarring, pigmentation changes, or other unforeseen outcomes. I accept that no guarantees have been made regarding results.


    6. Liability Waiver

    I hereby release Allured Aesthetics, its owner(s), employees, contractors, and training staff from any liability for any losses, damages, costs, or injuries, including allergic reactions, that may result from the treatments I receive. I understand that this waiver applies to all services provided now and in the future until revoked in writing.


    7. Photo/Video Release

    I grant Allured Aesthetics permission to use photographs and/or video recordings taken during my visit for documentation, promotional, marketing, or educational purposes, with identifying information kept confidential.

     
    8. Agreement to Terms & Conditions

    By submitting this form and/or booking an appointment, I affirm that I have read, understood, and agree to the policies, terms, conditions, and content of this consent in its entirety.

  • I have read the above information. If I have concerns, I will address them with my esthetician, Chiese McClain. I give permission to Chiese McClain to perform any of the procedures we have discussed, and will hold her harmless from any liability that may result from this treatment. I have accurately answered the questions above, including all known allergies, prescription drugs, or products I am currently ingesting or using topically. I understand that my esthetician will take every precaution to minimize or eliminate negative reactions as much as possible. In the event I may have additional questions or concerns regarding my treatment, I will consult the esthetician immediately. I agree that this constitutes full disclosure, and that it supersedes any previous verbal or written disclosures. I certify that I have read, and fully understand, the above paragraphs and that I have had sufficient opportunity for discussion to have any questions answered. I understand the procedure and accept the risks. I do not hold the esthetician, whose signature appears below, responsible for any of my conditions that were present, but not disclosed at the time of the skin care procedure, which may be affected by the treatment performed today.

  • By signing this form, I acknowledge and understand the terms of the service, booking policies, and the information listed. This agreement will remain in effect for the duration of the service and any proceeding services conducted by Allured Aesthetics in the future. If any information changes, I will inform Chiese McClain*

  • Date*
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  • Esthetician: Chiese McClain 

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