Consent Form

Name

First NameLast Name

Date of Birth

Date

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Email

example@example.com

Emergency Contact Details

Name and phone number

Known Allergies;

Latex, fragrances, nuts, tint/dye?

Skin Sensitivities;

Eczema, rosacea, or reactions to cosmetic products?

Your current skincare routine;

Retinoids, Retintol, AHAs/BHAs

Are you currently using any of the following?

If “other” please list;

Do you suffer from any of the following Medical Conditions;

Is there a chance you may be pregnant?

Have you had this service done before? Have you had any negative reactions?

I give consent for photos to be taken for advertisement purposes on social media.

1.) Accuracy of Infortmation; I certify that I have read this form completely and have provided a thorough, accurate, and honest medical and lifestyle history. I understand that withholding information about my health, medications, allergies, or skin conditions can lead to adverse reactions or injury during or after the treatment. I agree to update CJB Artistry of any changes to my medical history prior to future appointments.

2. Acknowledgement of Risks; I understand that the beauty treatments offered by CJB Artistry, including but not limited to waxing, tinting, eyebrow lamination, eyelash lifting, carry inherent risks. These risks may include, but are not limited to: skin irritation, redness, swelling, burning, allergic reactions, infection, pigment changes, scarring, or hair loss. I accept these risks and choose to proceed with the treatment voluntarily.

3. Post-Treatment Aftercare; I acknowledge that I have been provided with verbal and/or written aftercare instructions. I understand that the success of this treatment and the prevention of side effects depends heavily on my adherence to these instructions. I agree to follow the guidance carefully.

4. Release of Liability; By signing below, I expressly release and hold g harmless CJB Artistry, its owners, operators, independent contractors, and employees from any and all liability, claims, demands, actions, or causes of action arising out of any damage, loss, injury, or allergic reaction resulting from the services received, unless caused by gross negligence.

Signature

Date