Open the link sent by the beautician and fill out the salon spa waiver by using your mobile devices.

Welcome to Labelle Spa/Luxury Spa!

Please take your time to read and answer all questions. Thank you!

Facial Consent Form

Please fill your name: *

Please enter your full name.

Phone number: * Please enter your phone number.

Email: * Please enter your email.

How did you hear about Labelle Spa/Luxury Spa? *

Google

Class Pass

Instagram/Facebook

Friend/Family

Groupon

Other

Please select at least one choice above.

Do you have any current medical conditions? *

Yes

No

Please select at least one choice above.

If Yes, please list (if no type NO): Please enter your answer here.

Do you have any prevalent allergies? *

Yes

No

Please select at least one choice above.

If Yes, please list (if no type NO) * Please enter your answer here.

Do you have pacemakers or metal implants in your body? *

Yes

No

Please select at least one choice above.

Have you had Botox and/or other injections within the last 2 weeks? *

Yes

No

Please select at least one choice above.

Have you had chemical peel of any kind within the last 2 weeks? *

Yes

No

Please select at least one choice above.

Have you waxed within the past week? *

Yes

No

Please select at least one choice above.

Are you exposed to the sun on a daily basis or use a tanning bed? *

Yes

No

Please select at least one choice above.

Are you pregnant or trying to become pregnant? *

Yes

No

Please select at least one choice above.

How far along? (if not type NO) * Please enter your answer here.

Any notes for us? * Please enter your answer here.

By my signature below I understand that redness, sensitivity, peeling or other reactions may occur from facial treatments. If I experience any discomfort during the session, I will immediately inform the esthetician so that the products and/or technique may be adjusted to my level of comfort. I further understand that esthetician are not qualified to diagnose, prescribe or treat any disease or illness and that a facial should not be a replacement for medical treatment. The treatments I receive here are voluntary and I release Luxury Spa, inc/ Skin Center LLC and/or skin care professional from liability and assume full responsibility thereof.

Your Signature *

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Please Enter Date *

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Your signature here: *

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