consent form
CONSENT & PATCH TEST FORM
WHAT TREATMENT ARE YOU INTERESTED IN BOOKING ?
HAVE YOU HAD THIS TYPE OF TREATMENT BEFORE?
WHAT DO YOU CONSIDER YOUR SKIN TYPE?
ARE YOU PREGNANT?
ARE YOU OVER 18?
DO YOU HAVE ANY ALLERGIES I SHOULD KNOW ABOUT? PLEASE SPECIFY THEM ALL.
DO YOU HAVE ANY INJURIES OR MEDICAL CONDITIONS THAT MIGHT AFFECT THE TREATMENT?
patch test consent
I received a patch test at HK hair & beauty salon.
The patch test has been obtained and releases HK hair & beauty salon from any liability related to any allergies or other reactions to applied pigments.
I have been informed that reactions can occur at any time in the future. Sun exposure can also cause a comeback with the pigments (Colours & Products).
1) I give my permission to receive Threading, Hair Treatment, Chemical & Carbon Peel, Eye Treatment and Scrub, Hydra Facial, Microdermabrasion, Microblading, Microneedling, Electronic facial treatments, Dermaplaning, Laser removal and Waxing services. 2) Where an Eye Treatment has been completed I am fully aware that even with patch testing there is only a limited amount of exposure, and that a complete treatment may have a different outcome, I will contact my therapist if any irritation, side effect or unwanted issue arrives that is a direct cause of any eye treatment that is carried out. 3) I understand that the therapist does not diagnose illnesses or injuries, or prescribe medications. 4) I have clearance from my doctor where necessary to receive the treatment/therapy I am looking for. 5) I fully understand the risks associated with massage therapy, facials, and waxing including, but not limited to • Superficial bruising or redness • 6) I understand the importance of informing my therapist of all medical conditions and medications I am taking, and to let the therapist know about any changes to these at any ongoing appointments. I understand that there may be additional risks based on my physical condition. 7) I understand that it is my responsibility to inform my therapist of any discomfort I may feel during the session so he/she may adjust the treatment accordingly. 8) I understand that the therapist or I may terminate the session at any time. 9)Photos of your treatments may be taken to aid in record keeping and to be used with your permission on social media to help advertise the services available. 10) I am aware that our appointments are subject to late cancellation due to guidelines in place with CV19 regulations. 11) I have been given a chance to ask questions about the session and my questions have been answered.
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