• Brow Services Consultation & Consent Form

    Please carefully read and complete this form before receiving brow waxing, tinting, and/or lamination services at Neu Moon Esthetics. The information provided will help determine whether your selected service is appropriate for you.
  • Date
     - -
    2 digit month, 2 digit day, 4 digit year

  • HEALTH & SKIN HISTORY

  • Pregnant or breastfeeding?*
  • Have you used ACCUTANE (isotretinoin) within the past year?*
  • Have you had any recent facial treatments, chemical peels, or laser treatments, or other professional treatments?*
  • Have you ever experienced an allergic reaction, irritation, or other adverse reaction to brow tint, hair dye, brow lamination, lash lift, or similar cosmetic products?*
  • Currently taking ANY medications that may increase skin sensitivity or photosensitivity?*
  • Currently using any of the following?*
  • Do you currently have any of the following medical conditions that may affect your skin or healing?

  • AGE & CONSENT

  • Are you 18 years of Age or older? If under 18, a parent or legal guardian must be present to provide consent where required.*

  • IMPORTANT WAXING & SKIN-SENSITIVITY INFORMATION

  • Certain medications, skincare products, recent treatments, and skin conditions may increase the risk of irritation or skin lifting during waxing.

    Please inform your esthetician before treatment if you are currently using or have recently used medications or products such as:


    Accutane/isotretinoin
    Adapalene/Differin
    Retin-A/Tretinoin
    Renova
    Tazarotene
    Other prescription retinoids or exfoliating medications


    Skin sensitivity may also be increased by factors such as recent sunburn, certain medications, active skincare ingredients, recent professional treatments, or certain skin conditions.

    Your esthetician will review your information and determine whether waxing, tinting, and/or lamination is appropriate before beginning the service.

  • CLIENT CONSENT & ACKNOWLEDGEMENT

  • I confirm that the information I have provided on this consultation form is accurate and complete to the best of my knowledge. I understand that providing accurate information regarding my health history, medications, skincare products, allergies, sensitivities, and previous treatments is important in determining whether brow waxing, tinting, and/or lamination is appropriate for me.

     

    I understand that brow waxing, tinting, and lamination are cosmetic services and that each treatment may produce temporary effects such as redness, sensitivity, itching, dryness, irritation, or swelling. Waxing may also result in temporary bumps or tenderness, and in some cases may cause skin lifting or irritation.

     

    I understand that brow lamination involves chemical solutions designed to restructure and style the brow hairs. Results, processing time, and the longevity of the treatment may vary depending on my individual hair type, condition, skincare routine, previous treatments, and aftercare.

     

    I understand that brow tinting involves the application of professional tint products and that, although precautions are taken, sensitivity or an allergic reaction may occur. I agree to inform my esthetician of any known allergies, previous reactions to tint or cosmetic products, or changes in my health or skincare routine before receiving the service.

     

    I understand that my esthetician may modify, postpone, or decline a service if my skin, brow hair, health history, medications, skincare products, recent treatments, or other circumstances indicate that the service may not be appropriate at that time.

     

    I understand that individual results vary and that no specific result, color, shape, or duration of a brow treatment can be guaranteed.

     

    I agree to follow the aftercare instructions provided by my esthetician. I understand that proper aftercare is important for maintaining the results of my treatment and supporting the health of my skin and brow hair.

     

    I agree to notify my esthetician before future appointments if there have been any changes to my medications, skincare products, allergies, sensitivities, pregnancy or breastfeeding status, recent professional treatments, or skin condition.

     

    I understand that I may communicate any concerns, discomfort, or unusual reactions to my esthetician during or after the service.

     

    By signing below, I acknowledge that I have read and understood this Brow Services Consultation & Consent Form, have had the opportunity to ask questions, and voluntarily consent to receive the selected service from Neu Moon Esthetics.

  • I acknowledge that I have read and understood this form and agree to the terms.*
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