Client Consent and Intake Form
I certify that the information entered is correct to the best of my knowledge. In accordance with the law, Esthetics/Skin Care Therapy cannot cure, treat, prevent or diagnose any condition. These treatments are used as regimens for improving skin appearance and wellness. Information exchanged during any session should be given at my own discretion.
Because certain esthetics treatments should not be performed under certain medical conditions, I affirm that I will state all my known medical conditions and answer all questions honestly. I agree to keep the esthetician updated as to any changes in my health prior to any future sessions and understand that there shall be no liability on the esthetician’s part nor on the part of Wonder Spa, LLC and its affiliates should I fail to do so.
The estheticians and staffs of Wonder Spa reserve the right to refuse service to anyone for any reason.
I fully understand that the esthetician performs his/her services within the parameters of esthetics, using skin care products, machines/equipment, and therapies. I fully understand that the esthetician is not a doctor, dermatologist, or psychiatrist and does not portray himself/herself to be.
If I experience any pain or discomfort during the session, I will immediately inform the esthetician so that the products and/or techniques may be adjusted to my level of comfort.
By submitting this form, I verify that I have read and fully understand the above statements and agree to them. I understand that there are no guarantees or refunds as to the results of this service. The treatment I receive here is voluntary and I release the esthetician and Wonder Spa, LLC from liability and assume full responsibility thereof. I hereby agree to all of the above and grant my permission to have this treatment performed on me. I consent to the treatment performed by Wonder Spa and will be financially responsible for any charges incurred at Wonder Spa.
Please answer the following questions so that we may have a better understanding of your general health and lifestyle, thereby enabling us to analyze and assess your skin care needs.