Skin Analysis Form

Client Sunbed Form

Tanning units emit ultraviolet radiation such as the natural sun. Overexposure to ultraviolet radiation (e.g. sunburn) may cause skin cancer and skin aging. People with fair skin (skin type 1) who burn easily will not be permitted to use the tanning unit. Further intentional exposure to sunlight or a tanning unit must be avoided for the next 48 hours. Protective eyewear must be worn at all times while undergoing tanning unit exposure. No person under the age of 18 years is permitted to use a tanning unit.

Full Name*

First NameLast Name

Address*

Street Address

Street Address Line 2

City

Birth Date*

DayMonthYear

Phone Number*

E-mail*

Medications*

Allergies*

Is there any history of Melanoma in your family or a history of sunburn?*

Have you tanned in the natural sun or another tanning studio in the last 48 hours?*

Are you pregnant? (Solaris do not advise sunbed use while pregnant)*

Skin Analysis

1. Eyes*

2. Natural hair colour*

3. Natural skin (untanned)*

4. Freckles*

5. Occurance of sunburn*

6. How well does your skin tan*

7. Does your skin tan immediately after sunbathing*

8. Facial sensitivity to the sun*

9. Experience of tanning on sunbeds*

10. Last tanning session (natural or sunbed)*

Points Total:

0 - 7 POINTS = SKIN TYPE 18 - 16 POINTS = SKIN TYPE 217 - 25 POINTS = SKIN TYPE 326 - 40 POINTS = SKIN TYPE 4

Solaris Tanning Policies:

• No person under the age of 18 years is permitted to use a tanning unit

• All new clients must start with the advised session time and gradually increase. Staff will recommend what your next session time will be

• Avoid using sunbeds when taking medication or antibiotics, this can cause skin to become photosensitive

• No person with skin type 1 is permitted to use a tanning unit

• Protective goggles must be worn

• Always allow 48 hours between sessions with a maximum of 3 sessions in a 7 day period

Client Agreement:

Solaris Clinic care for your safety, if you do not wish to follow these regulations, staff do have the right to refuse service. I have read the contents of this client release and informed consent form carefully and state that I am not aware of any medical condition or other reason that would prohibit me from tanning at Solaris Clinic.

Signature*

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