• Facial Intake Form

  • Self Skin Analysis

  • How would you classify your skin type? (Check all that apply
  • What are your specific skin concerns?
  • Any other reasons for a facial besides your concerns?
  • Give us an idea of what you typically use on your skin daily?
  • Any known allergies?
  • Have you ever been diagnosed with eczema, psoriasis, or rosacea on the face or neck?
  • Are you currently using any products that contain:
  • Your Medical History

  • Have you had experienced any of these health conditions in the present or past?
  • Female Clients

  • Are you pregnant or breastfeeding?
  • Are you taking birth control?
  • Are you ok with before and after pictures being shared on our website and/or social media accounts?
  • Acknowledgement and Wavier

  • Acknowledgement and Waiver By submitting this document, I hereby agree to have this facial and or body treatment and future treatments be performed on me. I am aware that even with natural ingredients there is a remote chance of an allergic reaction and there is a possibility of an adverse reaction to product used in facials.  I am also aware that certain services should not be performed with certain medical conditions. I have disclosed all my known medical conditions, allergies, medications and answered all questions honestly on the above form and agree to update  Joosy Beauty, LLC. as to any changes with my medical history or skincare regimen. I acknowledge that the estheticians and staff at Joosy Beauty, LLC do not provide medical advice and I accept full responsibility to seek out such advice before receiving any services or products from Joosy Beauty, LLC I agree to allow my client profile to be updated with visual media documentation of any skin changes that may result from services received and products recommended. I am aware that this documentation may  Joosy Beauty networks and platforms. I hereby release, discharge and waive any and all claims against and Joosy Beauty, LLC and each of their partners, employees, representatives or any person(s) performing services or applying any products at World's Famous Dermatologist and Joosy Beauty, LLC, including from liability and responsibility for any and all illness, injuries, damages, claims, rights and causes of action of any kind or nature, that may occur during or arising out of any services or products received on this and any future dates. I expressly assume and accept the risk for any injuries sustained. I understand that all sales are final, and any refund or compensated amount is not guaranteed. I have read this entire document and agree to its terms.

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