The Beauté Emporium Haus — Client Consultation & Consent Form

  • 1. PERSONAL INFORMATION

  • Date of Birth:*
     - -

  • 2. SERVICE REQUESTED

  • Service Requested*

  • 3. PREVIOUS SERVICE HISTORY

  • 4. MEDICAL & BEAUTY HISTORY

  • Please check all that apply:
  • Did you experience any irritation, allergic reaction, or complications?*
  • Medical & Beauty History Options*

  • 5. SURGICAL HISTORY

  • Have you had any cosmetic, facial, eye, scalp, brow, or other surgery?*

  • 6. PATCH TEST REQUIREMENT

  • For Korean Lash Lift, Brow Lamination, Henna Brows, Hair Color, and any chemical-based service, a patch test is required 48-72 hours (2-3 days) prior to your appointment. Failure to attend the required patch test appointment will result in:
    • Immediate appointment cancellation
    • Loss of deposit
    • No refunds

  • 7. CONSENT & RELEASE

  • I acknowledge that beauty services may involve risks including but not limited to:
    • Redness
    • Irritation
    • Swelling
    • Allergic Reactions
    • Sensitivity
    • Hair Breakage
    • Unexpected Results
    I certify that I have disclosed all medical conditions, allergies, medications, previous reactions, and surgical procedures that may affect my service.

  • 8. CANCELLATION & DEPOSIT POLICY

  • All deposits are non-refundable. No-shows, same-day cancellations, or failure to attend a required patch test appointment will result in forfeiture of the deposit.

  • 9. CLIENT AGREEMENT

  • By signing below, I acknowledge that I have read and understand the information above and voluntarily consent to receive services at The Beauté Emporium Haus.
  • Date*
     - -
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  • Should be Empty: