Spray Tan Consent Form

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.Format: (000) 000-0000.

How did you hear about us?

If friend /client referral, please list name so they can get reward points

Are you over the age of 18?

How did you hear about us?

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

Did you shower in the past 4 hours?

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

Do you plan on spending time in the water?

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

Do you have any allergies?

If yes, please list:

Are you currently breastfeeding or pregnant?

If yes or maybe, do not do spray tan

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

If yes, please explain

Do you have any other health concerns?

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:

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