Evergreen Esthetics
PARENTAL CONSENT FORM
As the parent or legal guardian of
(Minor's name),
I give permission for him/her to have the following services performed.
I confirm that I have read and understand all information on the applicable forms for this treatment and or services and accept responsibility on my child's behalf for any disclosures or liability described on those forms. I agree to supervise any home care procedures that are recommended as a result of the treatment.
Parent or Gaurdian Printed Name
Parent or Gaurdian Signature
Date
-
Month
-
Day
Year
Date
This form must be signed in person by the parent or guardian at the time of service witnessed by the esthetician
Submit
Should be Empty: