Sign up - Beauty Saint Aesthetics

Name:

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Full Legal Name:

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Gender / Pronouns

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Phone Number:

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Email Address:

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Street address

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Apt, suite, etc. (optional)

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City

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State

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ZIP code

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Date Of Birth:

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Referred by or how did you find us?

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Do you follow a restricted diet? (Such as Vegan, gluten free, etc)

Yes

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I understand, have read and completed this questionnaire truthfully. I agree that this constitutes full disclosure, and that it supersedes any previous verbal or written disclosures.

Yes

I understand that withholding information or providing misinformation may result in contraindications and/or irritation to the skin from treatments received.

Yes

I am aware that it is my responsibility to inform the esthetician/skin care therapist of my current medical or health conditions and to update this history.

Yes

I understand the treatments I receive here are voluntary and I release this institution and/or skin care professional from liability and assume full responsibility thereof.

Yes

Retainers &/or deposits are non-refundable/non-transferrable.

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Cancellations should be made prior to 48 hrs to avoid additional fees up to full amount.

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