New Tanning Client Intake
Please fill this form out if it's your first time spray tanning at Celebrity Skin
Name
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
example@example.com
Phone Number
-
Area Code
Phone Number
Date
-
Month
-
Day
Year
Date
How did you hear about us? If from a friend, add their name to the "other" section:
Google
Yelp
Facebook
Twitter
Instagram
Other website
Friend
Other
Skin type:
Dry
Oily
Combination
Acne prone
Sensitive
Normal
Other
Are you pregnant?
No
Yes/maybe
Have you ever tried any of the following sunless products in the past?
Spray tan automatic booth
Airbrush technician
Sunless lotion
Sunless spray
None of the above
Other
Have you ever had a reaction to any of the above products? If yes, please describe in "other" section:
No
Yes
Other
Do you have any allergies? If so, please list in "other" section:
No
Yes
Other
Are you over the age of 18? Please type your birthday in "other" section for special deals:
Yes
No
Other
Are you allergic to DHA?
No
Yes
If yes, do you have a doctor's permission to tan?
Yes
No
If you're under the care of a doctor, please indicate any reason why it may be unsafe for you to tan in "other" section:
N/A, not under care of doctor
Other
Spray tanning is accomplished by application of a solution containing the active ingredient DHA (dihydroxyacetone). DHA is considered to be safe and has been FDA approved for cosmetic use. DHA is listed in the food, drug and cosmetic act as a color additive for use in imparting color to the human body. However, its use in cosmetics- including sunless tanning products- is restricted to external application.
DHA reacts with the skin’s amino acids, resulting in a tan similar looking to that of the sun. The darker your skin, the darker spray tan color you can have and still look natural. Overexposure to DHA does not cause skin damage but can result in possible orange coloring of the skin. Please follow the advice of the spray tan technician.
What you wear is up to you and your level of comfort.
Men are required to wear bottoms.
It is recommended that you wear an old dark swimsuit or underwear. While the solution should wash out of dark clothing, it is best to wash the swimsuit or clothing as soon as possible.
You will have an immediate tan after your airbrush tanning session due to the cosmetic bronzer. The sunless tan will develop gradually over the next 8-12 hours. The cosmetic bronzer will wash off after your first shower and you will be left with a more subtle tan. This is normal.
After your session,
avoid
tight fitting clothing/shoes, leather, perspiring, and water.
If you have any concerns at all about an allergic reaction, please ask for a list of ingredients prior to your tanning session.
We always recommend a trial run for a tan intended for important occasions such as weddings, photography sessions, modeling, etc.
Warning
– This product does not contain a sunscreen and does not protect against sunburn. Repeated exposure to the sun/uv rays without the use of sunscreen may increase the risk of skin aging, skin cancer, and other harmful effects to the skin even if you do not burn.
This process has been explained to me and I hereby agree to allow a technician at Celebrity Skin Chicago to apply the sunless tanning solution to my skin. To my knowledge, I have no medical condition or allergy which would preclude me from having this procedure done. I agree to hold Celebrity Skin Chicago harmless of any and all medical complications that may arise. I have been advised to discontinue use if any reaction occurs. I have read and fully understand this client release and informed consent form and hereby agree to accept all of the provisions.
Client signature (or signature of guardian if client is under 18)
Submit
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