**TREATMENT GOALS
What concerns are you interested in treating? (✓ Check all that apply)
**MEDICAL & SKIN HISTORY
Do you have any allergies?
Have you had reactions to:
Do you have sensitive skin?
Do you have any skin conditions (acne, eczema, psoriasis, etc.)?
Are you using any of the following? (✓ Check all that apply)
Recent treatments in the last 4 weeks?
Medications currently taking:
Have you ever used Accutane?
Any cosmetic procedures (Botox, filler, surgery)?
Tanning or sun exposure in the last 2 weeks?
Used self-tanning products recently?
Do you have any of the following:
**FEMALE CLIENTS ONLY
Are you currently or potentially:
**SKINCARE HABITS
What skincare products are you currently using?
Ever had reactions to skincare products?
Would you like skincare recommendations?
Do you prefer your aesthetician to wear a mask during treatment?
How did you learn about us?
**CONSENT FOR IMAGE USE
DISCLAIMER & INFORMED CONSENT
- I voluntarily consent to receive facial treatment at TR• Beauty Spa.
- I understand potential risks include temporary redness, irritation, dryness, or breakouts.
- I have disclosed all medical and skin history truthfully.
- Skincare services do not replace medical treatment.
- I acknowledge that TR• Beauty Spa has a no refund policy once the service has been performed.
- I allow my aesthetician to adjust the treatment plan if necessary
- I understand there is no guarantee of results.
- I confirm I am over 18 and legally able to give consent.
- I understand that my personal and medical information will be kept confidential and used only for treatment purposes.
By signing below, I confirm that I have read and fully understand the terms above.
