Client Intake + Consent Form

  • Client Intake + Consent Form

    *** You only need to fill out this consent/intake form once—unless something new has changed in your health history***

  • Client Information

  • Date of Birth
     - -
  • Format: (000) 000-0000.
  • What services/ treatments are you looking to book now or future?*
  • Describe your skin type: Check all that apply.

  • Client Intake Information

  • Facial services/ Dermaplane/ Microdermabrasion Services
  • High Frequency Service
  • Waxing Services
  • Brow Lamination/ Brow Tinting/ Brow Staining Services
  • Lash Lift/ Lash Tint Service

  • CLIENT MEDICAL HISTORY

  • Please complete this form honestly and thoroughly. Your information helps ensure your safety and the best possible results during your service.

  • Medical Conditions*

  • Booking Policies

  • Cancellations & Rescheduling:

    Currently, no fees are charged for cancellations or rescheduling; however, please notify me at least 24 hours in advance if you need to change your appointment.


    No-Shows:

    Clients who do not show for a scheduled appointment or arrive more than 10 minutes late will be considered a no-show and charged 50% of the total appointment cost. A card will be required on file to secure appointments. If a card is not provided, future appointments cannot be scheduled until the fee is paid.


    Deposits:

    Some services require a deposit. If booking online, a payment link will be sent automatically. For appointments booked via text or phone, you will be provided with instructions for paying the deposit. If a deposit is not paid, the appointment will not be held.


    Cards on File:

    When booking online, you may be prompted to add a card on file to cover any applicable fees.

    Confirmations:

     For fairness to all clients, appointments must be confirmed via text or email. If not confirmed, the appointment will be canceled.


    I understand that life happens—communication is greatly appreciated to help accommodate any changes!

  • Social Media

  • I give Sel the Esti+ Sel the Waxer (Selena Munoz) permission to post photos or videos of my service results (before & after) for marketing and promotional purposes.*

  • Client Consent

  • I understand that the treatments and services I receive from Sel the Waxer / Sel the Esti (Selena Munoz) are for professional skin and beauty enhancement purposes only. I acknowledge that individual results may vary, and no guarantees can be made regarding the outcome of any service.

     


    I have disclosed all medical conditions, medications, allergies, and skincare products that may affect my treatment, and I agree to update Sel the Waxer / Sel the Esti with any changes to my health or skincare routine prior to future appointments. I understand that failure to disclose this information may result in adverse reactions or injury, for which I take full responsibility.

     


    I understand that certain treatments such as facial services, dermaplane, microdermabrasion, waxing, high frequency, brow lamination, brow tint, lash lift, and lash tint may cause temporary redness, sensitivity, irritation, or other minor side effects. My provider, Selena Munoz, has explained the treatment process and possible risks, and I have had the opportunity to ask questions.

     


    I consent to receiving these services and to the use of professional skincare products during my treatment. I release Sel the Waxer / Sel the Esti (Selena Munoz) from any liability for injury, damage, or unforeseen reactions that may occur as a result of these professional services.

     


    By signing below, I confirm that I have read, understood, and agree to the terms of this consent form.

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