Liability Waiver

Please fill out the following form.

First name

Last name

Email

Phone

Date of birth

Month

Day

Year

Do you have any skin allergies?

Yes

No

Have you had any esthetic treatments in the past 14 days?

Yes

No

If you answered yes to any of the above questions please elaborate.

By signing this document, I acknowledge the inherent risks and voluntarily assume full responsibility for any injury, damage, or loss that may result from my participation. I hereby waive and release the business, its owners, and its staff from any and all liability, past, present, and future, relating to the services provided.

Signature

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