• Skincare Client Intake & Consent Form

    Please complete this form before your skincare appointment so your esthetician can safely customize your treatment.
  • Format: (000) 000-0000.
  • Date of Birth*
     - -
  • How would you describe your skin type?
  • What are your main skin concerns today?*
  • How does your skin usually react to new products or treatments?
  • Are you currently using any of the following?*
  • Do you have any known allergies or sensitivities?*
  • Have you had any of the following in the last 2 weeks on the treatment area?*
  • Are you currently pregnant or nursing?*

  • Informed Consent & Acknowledgment of Services

     
    Facials, Waxing, Head Spa & Related Esthetic Services

     
    General Consent

     
    I understand that the esthetic services provided by HD Skincare Solutions are non-medical cosmetic treatments intended to enhance the appearance, comfort, and overall condition of the skin, scalp, and hair. These services may include, but are not limited to, facials, waxing, head spa services, scalp treatments, and related esthetic procedures.

     
    I acknowledge that individual results vary and that no guarantees have been made regarding specific outcomes.

     
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    Possible Reactions & Sensations

     
    Depending on the service performed, I understand that I may experience temporary and expected reactions, including but not limited to:

    •Redness, warmth, or flushing

    •Mild swelling, sensitivity, or tenderness

    •Temporary irritation, itching, or tightness

    •Dryness, flaking, or light exfoliation (facial services)

    •Ingrown hairs, follicular sensitivity, or minor bruising (waxing services)

    •Scalp or neck tenderness, or mild lightheadedness (head spa services)

     
    These reactions typically subside within a few hours to several days, depending on the service received and individual response.

     
    I understand that the absence of visible peeling, flaking, or hair regrowth delay does not indicate that a service was unsuccessful, as results may occur on a cellular level and vary by individual.

    Important Information (Chemical Treatments)

    1. This professional esthetic in-clinic service is designed to improve the texture and appearance of your skin.

    2. Depending on the service, you may experience some temporary erythema, irritation, or warm flushing.  During the next few hours, you may experience some tightening of the skin which may last for several days.

    3. For some individuals, a light flaking begins within 48 hours.  It is impossible to pre-determine how much flaking will occur.

    4. Depending on the service, the sloughing process usually subsides within 2-7 days.

    5. Pigment may appear darker on the surface before fading.

    6. Lack of flaking or "peeling" is NOT an indication that the service was unsuccessful. If you do not notice actual peeling, you are still recieving all the benefits of your service such as improvement of skin tone, texture, and appearance of fine lines and hyperpigmentation. There are a number of reasons why some people may not experience peeling.

    7. Results may vary with each service and individual client.

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    Waxing Services Acknowledgment

     
    I understand that waxing involves the removal of hair from the follicle and may result in temporary redness, irritation, ingrown hairs, folliculitis, bruising, or, in rare cases, skin lifting—especially if I am using retinoids, exfoliating agents, acne medications, or have compromised skin.

     
    I confirm that I have disclosed all relevant skincare products, medications, and conditions prior to receiving waxing services.

     
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    Head Spa & Scalp Services Acknowledgment

     
    I understand that head spa and scalp services involve manipulation of the scalp, neck, and upper shoulders and may include massage, water, steam, topical products, and manual techniques.

     
    I acknowledge that temporary scalp sensitivity, tenderness, or lightheadedness may occur and agree to immediately inform my provider if I experience discomfort at any time during the service.

     
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    Medical Disclosure & Contraindications

     
    I confirm that I have disclosed all relevant medical conditions, allergies, medications (both topical and oral), pregnancy status, and recent cosmetic or medical procedures. I understand that failure to disclose this information may increase the risk of adverse reactions.

     
    I acknowledge that these services are not medical treatments and are not a substitute for medical care or diagnosis.

     
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    Aftercare Responsibility

     
    I understand that proper aftercare is essential for optimal results and agree to follow all post-treatment instructions provided. I acknowledge that failure to follow aftercare recommendations may affect results or increase the likelihood of irritation or adverse reactions.

     
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    Consent & Release

     
    I hereby give my informed consent to receive esthetic services from HD Skincare Solutions. I voluntarily release and hold harmless HD Skincare Solutions, its owners, employees, and contractors from any claims or liability arising from these services, provided they are performed in accordance with professional standards.

     
    I acknowledge that all procedures, potential risks, and aftercare instructions have been explained to me to my satisfaction, and that I have had the opportunity to ask questions and receive clear answers.

     
    If I am under the care of a physician, I confirm that I have consulted with them prior to receiving services.

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