Consultation Form
Name
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Date of Appointment
-
Month
-
Day
Year
Date
Natural skin color:
Very fair
Fair
Light olive
Medium
Dark olive
Deep brown
How does your skin react to sun exposure?
Burns easily
Burns then tans
Tans easily without burning
Freckles or Moles?
Yes
No
Natural eye color:
Blue/Green
Hazel
Brown
Black
Natural hair color:
Blonde
Red
Light brown
Dark brown
Black
Skin conditions (eczema, psoriasis, rosacea, vitiligo):
Open cuts, wounds, or rashes?
Yes
No
Pregnant or breastfeeding?
Yes
No
Recent sunburn?
Yes
No
Allergic to DHA or tanning products?
Yes
No
Spray tan/self-tanner in last 2 weeks?
Yes
No
Recent exfoliation treatments? (waxing, sugaring, dermaplaning, facials):
Recently used Retinol, Accutane, or prescription skin products?
Yes
No
How often do you moisturize your skin?
Desired shade:
Light glow
Medium tan
Dark bronze
Special event date (if applicable):
Past spray tan turned orange or faded unevenly?
Yes
No
I understand the importance of following pre- and post-tan care instructions. (Please initial)
I understand that results may vary depending on my skin type and preparation. (Please initial)
Date
-
Month
-
Day
Year
Date
Submit
Should be Empty: