Consent Form

Consent Form
Name

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
I, First Name* Last Name* , agree to receive services from Genesis Fowler at Vivid Vibes.
(Please initial below)

I confirm:
I have disclosed all medical conditions, skin sensitivities, and allergies.
I understand the risks of receiving cosmetic services, including irritation, lifting, or allergic reactions.
I acknowledge that results vary depending on aftercare and maintenance.
I agree to follow post-care instructions.
I release Vivid Vibes from liability for any adverse effects resulting from services rendered.
I consent to photos/videos of my services being used for marketing or portfolio purposes.
Signature
Should be Empty: