SUGARING & SKINCARE INTAKE FORM
ABOUT YOU
(All information is confidential and will not be shared with or sold to other companies)
Any current or past health conditions? (Please check all that apply)
Do you have any other medical concerns or injuries that may be pertinent to your treatment?
Have you ever been treated for cancer? If yes, when and what type?
Have you used any of the following in the last 48-72 hours? (Please check all that apply)
Are you taking any other skin thinning medication? If yes, what type?
When was the last time you used a tanning bed or were exposed to the sun?
What is Your Current Skincare Regime
When did you last shave?
Have you been waxed in the past? If yes, when was your last visit?
Have you been sugared in the past? If yes, when was your last visit?
Legal Agreement
This Agreement (the "Agreement") is entered into between the undersigned client (referred to as "Client") and Salt & Rind (referred to as "Service Provider"), collectively referred to as the "Parties," with regard to sugaring treatments and skin treatments.
Consent and Release: Client understands and acknowledges that an adverse reaction may occur during or after the sugaring treatment or skin treatment. Any concerns or questions regarding the treatment should be promptly addressed with the esthetician. By signing this Agreement, Client consents to receive sugaring treatments and/or skin treatments at Salt & Rind, including but not limited to Facial Treatments and Hair Removal. Client hereby releases Salt & Rind, its officers, employees, agents, or assigns from any and all liability arising from or as a result of any treatment(s) received today and during all future appointments.
Health Disclosure: Client affirms that all information provided regarding known allergies, prescription drugs, or topical products being used is accurate. Client understands that the esthetician will take necessary precautions to minimize or eliminate negative reactions as much as possible.
Home Care Instructions: Client acknowledges that they have read and understood the post-treatment home care instructions. Client agrees to follow the esthetician's recommendations for a home care regimen that can minimize or eliminate possible negative reactions. If additional questions or concerns arise regarding the treatment or suggested home products/post-treatment care, Client agrees to consult the esthetician immediately. Client acknowledges that this Agreement constitutes full disclosure and supersedes any previous verbal or written disclosures. By signing this Agreement, Client certifies that they have read and fully understand the above paragraphs and have had sufficient opportunity for discussion to have any questions answered. Client understands the procedure and accepts the associated risks.
Salt & Rind ADA Certification: Client acknowledges that Salt & Rind is not ADA certified.
Use of Photos and Videos: Client grants Salt & Rind permission to use any and all photos and videos captured during the client's appointment for social media and marketing purposes.
CANCELLATION POLICY: Salt & Rind operates by appointment only. To ensure fairness to our estheticians and clients, the following cancellation policy is in effect:
Notification: Client must provide at least 24 hours' notice for cancellation or rescheduling of an existing appointment.
Credit Card Requirement: A credit card must be provided to schedule any appointments.
Late Cancellation or No Show: If Client fails to show up for an appointment or cancels less than 24 hours in advance, Salt & Rind may charge the credit card on file an amount equal to 50%-100% of the booked service.
Late Arrival: If Client is more than 5 minutes late to a 20-minute appointment or 10 minutes late to a 30-minute appointment, Salt & Rind reserves the right to reschedule the appointment or downgrade it to a shorter service.