BRB Makeup Appointment Intake

Makeup Appointment Intake

BELLA ROSE BEAUTY LLC // Licensed Cosmetologist
CLIENT INFORMATION
Name

First NameLast Name
Email
Phone Number
Format: (000) 000-0000.
Address

Street Address

CityState

Zip Code
EVENT DETAILS
Date of Service

MonthDayYear
Getting Ready Location
Address
Formal Events
Photo / Video Shoots
Other Event:
Please describe the event
Did anyone refer you?
(Name) or how did you hear about me
SKIN ANALYSIS
Skin Tone:
Skin Type:
Eyelash extensions
Sun burn/ peeling/ skin injury
Active acne, lesions, skin disease
Eczema, Psoriasis, Rosacea
Allergies to gluten, latex, food, metals, etc.
Facial, chemical peel, microneedling, laser, botox, fillers, etc.
IF YES: which procedure/ when was last treatment?
Anything else to be advised about?
I understand that cosmetic products may contain ingredients such as fragrances, preservatives (parabens, formaldehyde-releasers, phenoxyethanol, methylisothiazolinone), metals (nickel, chromium, cobalt), pigments (iron oxides, carmine), sunscreen agents, botanical extracts (lanolin, essential oils), adhesives (latex, resins), and other common additives which may cause irritation, allergic reactions, or sensitivity. Some pigments may cause temporary skin staining. I agree to disclose any known allergies or sensitivities to my makeup artist prior to application.
POLICIES

DEPOSITS:

A $100 NON-REFUNDABLE DEPOSIT IS REQUIRED AT TIME OF BOOKING TO SECURE YOUR APPOINTMENT. *ZELLE OR CASH PAYMENTS ONLY.

CANCELLATIONS:

I UNDERSTAND THAT LIFE HAPPENS, PLEASE NOTIFY ME AT LEAST 48 HOURS IN ADVANCE IF YOU NEED TO CANCEL OR RESCHEDULE YOUR APPOINTMENT. FAILURE TO DO SO WILL FORFEIT YOUR DEPOSIT. NO SHOWS WILL NOT BE ABLE TO REBOOK.

HEALTH AND SAFETY:

IF YOU ARE SICK/ HAVE SYMPTOMS OF ANY ILLNESS, I WILL NOT SERVICE YOU. CLIENT SAFETY AND SANITATION STANDARDS ARE TOP PRIORITY TO ME.
PHOTOGRAPH &

PUBLICITY RELEASE

I, the client, give my permission to use my image, likeness, and/or appearance as such may be embodied in any pictures, photos, video recordings, digital images, and the like, taken or made on behalf of Bella Rose Beauty llc. I agree that Bella Rose Beauty llc has complete ownership of such pictures, etc., including the entire copyright, and may use them for any purpose consistent with the Bella Rose Beauty company. These uses include, but are not limited to social media posts, illustrations, bulletins, exhibitions, videotapes, reprints, reproductions, publications, advertisements, and any promotional or educational materials in any medium now known or later developed, including the Internet. I acknowledge that I will not receive any compensation, etc. for the use of such pictures, etc., and hereby release Bella Rose Beauty llc and its agents and assigns from any and all claims which arise out of or are in any way connected with such use.
Date

MonthDayYear
Signature
Should be Empty:

Makeup Appointment Intake

CLIENT INFORMATION

EVENT DETAILS

SKIN ANALYSIS

POLICIES

DEPOSITS:

CANCELLATIONS:

HEALTH AND SAFETY:

PHOTOGRAPH &

PUBLICITY RELEASE