Form

Welcome to Raediency!

Hi beautiful! Before your appointment, please complete this form honestly and accurately.This ensures your treatment is safe, comfortable, and customized for your skin and needs.Please fill out the section(s) for the service(s) you’re receiving today — this form must be completed before your service begins.
Client Information

Please complete this section with your current and accurate information.
Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Emergency Contact (Name & Number)
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
How did you hear about Raediency?

Other
Service(s) Receiving Today:
Date

MonthDayYear
Date
CLIENTS WHO MAY NOT BE ELIGIBLE FOR TREATMENT

(Multiple choice - check all that apply to you)
Do you currently have or are you experiencing any of the following?
MEDICAL HISTORY

(Multiple choice - please check all that apply)
Do you have or have you ever had any of the following conditions?
Are you currently taking any medications or supplements?
If yes, please list them:
Do you currently use any of the followings products?
Allergies & Sensitivities
Please list any specific allergies or sensitivities:
Complete the section that matches your scheduled service
Waxing

This form must be filled out prior to your treatment.
Have you been waxed before?
Have you shaved or exfoliated in the past 24-48 hours?
Have you used any retinoids, acids, or acne products recently?
Brow Lamination

This form must be filled out prior to your treatment.
Have you had a brow lamination before?
Have you used brow tint or dye in the last 2 weeks?
Do you have any open cuts, irritation, or eczema around your brows?
Makeup

This form must be filled out prior to your treatment.
Have you had any allergic reactions to makeup products before?
Do you prefer me to use your personal makeup products (optional)?
Any specific skin concerns or products preferences?

Social Media & Marketing Permission

I give permission to Raediency to photograph or record me before, during, or after my service for marketing, social media, or promotional use. I understand that these images and videos may be used on platforms such as Instagram, the Raediency website, or other professional materials. I acknowledge that all photos and recordings will remain the property of Raediency and may be edited or shared for business purposes only. I understand that participation is completely voluntary, and I may withdraw my consent at any time by notifying Raediency in writing.
Client Consent & Acknowledgment

I confirm that the information I have provided in this form is true and complete to the best of my knowledge. I understand that certain medications, skincare products, or medical conditions may increase my skin’s sensitivity or affect how it reacts to treatments. I agree to inform Raediency of any changes to my health, skincare routine, or medications before future services. I acknowledge that results vary from person to person and that Raediency cannot guarantee specific outcomes. I understand that any irritation or reaction may occur due to undisclosed information or individual sensitivities, and I release Raediency from any liability in such cases. I give consent for Raediency to perform the service(s) I have selected — including facials, waxing, brow lamination, and/or makeup — and to use professional products and techniques best suited for my skin. I have read, understood, and agree to all service policies and procedures.
Date

MonthDayYear
Date
Client Signature
Client Release Form

I understand that the services provided by Raediency are intended to enhance the appearance and health of my skin but are not a substitute for medical care. I acknowledge that with any skincare or beauty treatment, there are potential risks, including but not limited to irritation, redness, allergic reactions, or sensitivity. I release Raediency from any liability for adverse reactions that may result from my treatment, including those due to undisclosed conditions, allergies, or sensitivities. I confirm that I have had the opportunity to ask questions about my service and that all questions have been answered to my satisfaction. By signing below, I voluntarily agree to proceed with the selected service(s).
Date

MonthDayYear
Date
Client Signature

You’re All Set!

Thank you for completing this form! Your honesty and thoroughness help Raediency provide safe, effective, and personalized treatments. By submitting this form, you confirm that all information is accurate and that you have read, understood, and agreed to the consent and release statements above. I look forward to giving you an amazing experience and helping you feel confident and radiant! Xoxo, RAEDIENCY
Should be Empty:

Welcome to Raediency!

Client Information

CLIENTS WHO MAY NOT BE ELIGIBLE FOR TREATMENT

MEDICAL HISTORY

Complete the section that matches your scheduled service

Waxing

Brow Lamination

Makeup

Social Media & Marketing Permission

Client Consent & Acknowledgment

Client Release Form

You’re All Set!