Sjolie Sunless Spray Tan

Name*

First NameLast Name

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Email*

example@example.com

Phone Number*

Please enter a valid phone number.

Age (required for service):*

How did you hear about us? *

Did you exfoliate 12-18 hours prior to your appointment?*

YesNo

Did you shower in the past 4 hours?*

YesNo

Are there any products (makeup, oils, etc) on your skin?*

YesNo

Do you plan on spending time in the water?*

YesNo

Do you plan on exercising in the next 24-48 hours?*

YesNo

Are you over the age of 18?*

YesNo

Do you have any allergies?*

YesNo

If yes, please list:

Are you currently breastfeeding or pregnant?*

YesNoMaybe

If yes or maybe, do not do spray tan

Do you or have you ever had any skin conditions or diseases?*

YesNo

If yes, please explain

Do you have any other health concerns?*

YesNo

If yes, please explain

Spray tanning involves the application of a solution containing the active ingredient DHA (Dihydroxyacetone). DHA is generally considered safe and has been FDA‐approved only when guidelines for protecting mucous membranes are followed. When considering the application of DHA products by spraying or misting, please answer the following questions:

Nose filters, eyewear, and Vaseline for your lips are available at each session. Please indicate whether you choose to use them or not:*

I choose to use these productsI do NOT choose to use these products

Everyone's skin is diﬀerent, and while the ingredients used in this procedure are generally regarded as safe for cosmetic use, there may be instances where individuals are allergic to specific components in the spray tan solution. If you have known allergies, please read the ingredients list and discuss this with your technician.

Be advised there is a small percentage of individuals may not react favorably to spray tanning. Therefore, we recommend not getting sprayed for the first time when your appearance is critical (e.g., wedding, special occasion, or prom). To ensure the best results, schedule a practice session 30 days before your event.

Caution: Pregnant or nursing women should consult their physician before using.

Warning: This product does not contain sunscreen and does not protect against sunburn. Repeated exposure of unprotected skin to UV light may increase the risk of skin aging, skin cancer, and other harmful eﬀects on the skin, even if you do not burn.

I have read this consent form carefully and am not aware of any medical conditions, allergies, or other reasons that would prohibit me from sunless tanning. I have received and understood the spray tan care instructions provided. While spray tan results typically last about 7‐10 days, I understand that individual results vary based on preparation, daily product use, activities, and skin type. To my knowledge, I have no medical condition or allergy that would prevent me from having this procedure. I have provided accurate information on this waiver and take sole responsibility for any reactions, staining of clothing, and personal belongings.

Please type name below acknowledging this form*

Signature

If the client is under the age of 18, a parent / guardian signature is required for services.

Parent / Guardian signature