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Home
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Shop
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BOOK NOW
Face massage
Additional massage
Facial care
Hydration and nourishing
Deep cleansing
Renewal and radiance
All facial procedures
Home
Services
Face massage
Additional massage
Facial care
About
Shop
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Face Style Bar – a destination
for care and self-love
BOOK NOW
+1 (720) 427-8550
Please ensure the form is completed before the appointment
1. CLIENT INFORMATION:
Name
Age
Gender
Contact number
Email address
2. SKIN CONCERNS:
1. What are your primary skin concerns? (Check all that apply)
Acne
Aging/Wrinkles
Oiliness
Sensitivity/redness
Uneven skin tone
Other (please specify)
2. Have you experienced any recent changes in your skin? (e.g., breakouts, dry patches, increased sensitivity)
3. MEDICAL HISTORY:
1. Do you have any known allergies? If yes, please specify:
2. Have you undergone any resent (past 6 months) skin treatments or surgeries?
3. Are you currently taking any medications or undergoing any medical treatments? If yes, please specify:
4. Are you currently pregnant?
YES
NO
5. Are you currently breastfeeding?
YES
NO
6. Do you have any known thyroid conditions?
YES
NO
4. TREATMENT PREFERENCES:
1. What specific results are you hoping to achieve from Face style bar skin care treatment?
2. Are you open to trying new products or treatments during your session?
3. Do you have any preferences regarding skincare products?
I, declare that I am of legal age and of sound mind. I have carefully read and fully understand the terms outlined in this consent form. I confirm that I have been provided with a clear explanation of the treatment I am about to receive, including its benefits, risks, and any potential complications.
I acknowledge that I have had the opportunity to ask questions, and all my concerns have been addressed to my satisfaction. I understand that withholding information or providing misinformation regarding my health history may impact the outcome of the treatment and could result in adverse reactions.
I confirm that I have provided accurate information regarding my health history and any medications or treatments I am currently undergoing. I understand that it is my responsibility to inform the esthetician of any changes to my health status that may affect the treatment.
I agree to follow all pre and post-treatment care instructions provided to me by the esthetician. I understand that failure to comply with these instructions may increase the risk of complications and affect the outcome of the treatment.
By signing below, I release Face Style. Bar and its staff from all liability for any injuries or complications that may occur during or following the treatment. I accept full responsibility for any adverse reactions or complications that may arise as a result of the treatment.
Emergency contact information:
Name
Phone number
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