• Consent Form

    Body Sculpting
  • Gender
  • Date of Birth*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Medical Conditions

  • Please select if you have experienced or are experiencing the following conditions:
  • Are you currently on your menstrual cycle? If yes, please be advised that treatment can cause cramping to be more excessive.
  • About Your Body/Skin

  • Client services and information are confidential. Written authorization is required from you to release any information. Your scheduled session is time set aside just for you. A deposit is required to book a session. A 24-hour cancellation notice is required. Your deposit will be kept if you do not cancel your appointent within the 24 hours or if you are a no show. A new deposit will be required at your next booking. Deposits must be paid through Zelle or Venmo. You will have a consultation with your body contouring specialist at the beginning of the appointment to go over treatment. At that time you will be given an opportunity to ask any questions or address any other concerns. The body sculpting specialist may end the session at any time for any reason. Inappropriate behavior is not tolerated and may be prosecuted to the full extent of the law.

  • Treatment Policies

  • Client Agreement

  • I understand that my data will be strictly confidential. Sunset Silhouettes does not sell, share, or resell information. I acknowledge that my skin might experience temporary irritation, tightness, redness, bruising, and/or slight swelling which usually dissipates within 72 hours depending on skin sensitivity. I acknowledge that if I am allergic to one or more ingredients in the products used, I may experience allergic reactions. I acknowledge that this treatment is strictly elective cosmetic procedure and no medical claims have been expressed or implied. I understand that body sculpting can be used to reduce fat deposits, but is not intended to be used as a weight loss solution. To assist with success of Ultrasonic treatment, it is advised that I follow these simple aftercare pointers: Complete 30 minutes of exercise within 12 hours of treatment as well as 3 times a week. Drink 2 liters of water a day. Avoid alcohol, fatty foods and caffeine 24-48 hours post treatment. Follow a well balanced, healthy choice diet, filled with fresh fruits and vegetables. To reserve my appointment, a $25 non-refundable deposit is required. The amount will be applied to the services rendered. I certify that I am over the age of 18. I voluntarily elect to receive body sculpting treatments after the nature and purpose of the treatment has been explained to me. I consent (to the best of my knowledge) that the answers I have given in this form are true and accurate and that I have not withheld any information that may be relevant to my treatment. I understand that the following conditions may prevent me from having this treatment at this time and verify that none of the following conditions apply to me. (Cardiac arrest, cancer, infected, sunburnt, or swollen skin, pacemaker, or pregnant/nursing) I give consent for all future treatments. I confirm that if I withold some important information and complications happen, Sunset Silhouettes and its staff will not be liable. I release Sunset Silhouettes and its staff of any liability associated with any injuries and/or current and future conditions resulting from the body sculpting procedures or products. I release Sunset Silhouettes and its staff and hold harmless against any claims, expenses, damages, and liabilities. By my electronic signature below, I agree to the treatment policies and client agreement above.

  • Do you give consent to Sunset Silhouettes to take, edit, alter, copy, publish, and make use of any and all pictures, videos, and audio taken of you during your treatment to be used for promotional and marketing purposes?
  • Date Signed*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Should be Empty: