Copy of Consent

Client Information

Full Name

Email Address

Date of Submission

Service Selection

Choose Service Category

Cosmetology Services Esthetician Services Nail Technician Services Eyelash & Eyebrow Specialist Services Permanent Makeup & Tattoo Services

Description of Potential Risks

I confirm that I have read and understood the risks associated with this procedure.

Allergy Test Recommendation

It is strongly recommended to perform a patch or sensitivity test at least 48 hours before any chemical-based treatments (e.g., adhesives, dyes, tints, lifting/laminating solutions).

I acknowledge this recommendation and:

Agree to complete an allergy test prior to the procedure. I decline the allergy test and voluntarily accept all potential risks.

Optional Consents

Please choose one:

I grant permission for the technician or salon to use my photos/videos for marketing purposes. I do not grant permission for the technician or salon to use my photos/videos for marketing purposes.

Client Responsibilities & Legal Consent

• Provide accurate medical history.
• Inform technician of any adverse reactions.
• Understand and accept risks.
• Release technician and salon from liability when professional standards are met.

I confirm that I have read, understood, and voluntarily agree to all statements and terms outlined in this form.

Electronic Signature & Legal Acknowledgment

By clicking “Submit,” I acknowledge that my responses constitute a legally binding electronic signature under U.S. law.

Thank you!

Your consent has been securely received.
We appreciate your trust and look forward to serving you safely.

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