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Release of Liability

Rad Skin LLC

5433 SE Woodstock Blvd.

Portland, OR 97206 

Chelsea Baggao

Esthetics License #: COS-FT-10180613  

 

 

 

 

 

Hair Removal And Skin Care Consent Form

By initialing the following statements you are giving Chelsea Baggao of Rad Skin LLC consent to perform sugaring (hair removal), and related skin care services. As well as relinquishing Chelsea Baggao and Rad Skin LLC of any and all liability. 

 

I understand sugaring can cause negative/allergic reactions, including but not limited to lifting, tearing, bruising, tenderness, inflamation, hives, ingrowns, etc.


I understand any questions answered falsely, or information withheld deems Chelsea Baggao and Rad Skin LLC not liable of any negative/allergic reaction due to sugaring (hair removal), or related skin care services performed by Chelsea Baggao of Rad SKin LLC.


I acknowledge I am agreeing to participate in sugaring (hair removal), and skin care services performed by Chelsea Baggao of Rad Skin LLC, and I am hearby releasing Chelsea Baggao and rad Skin LLC of any and all liability.


Cancelation Policy

Please cancel 24 hours in advance. Same day cancelations will be charged 50% of booked services.

No show appointments will be charged 100% of booked services.

If you no show 2 or more time Chelsea Baggao of Rad Skin LLC has the right to inforce prepaying, or a deposit on your appointments. 

I acknoledge and understand I have been notified of the Rad SKin LLC cancelation policy.


Social Media Release

I understand I may be asked by Chelsea Baggao of Rad Skin LLC for permission to take, and post photos to Rad SKin social media accounts. I have the right to select no, if no is selected then no photos can be posted. If yes is selected, Chelsea Baggao of Rad Skin LLC can post photos on Rad Skin LLC social media accounts. You will be given a yes/no option once you get to the questionaire portion of this waiver. Initialing is required no matter your answer.


 

 

First Participant's Name
First Name*
Middle Name
Last Name*
First Participant's Date of Birth*
Date of Birth
Information
How would you describe your gender identity? Check all that apply *
Female
Male
Transgender
Trans woman
Trans Man
Genderqueer
Genderfluid
Non-binary
Questioning
Other
What pronouns do you prefer?
Have you used Alpha Hydroxy Acid (AHA) or products containing glycolic within the last 48 hours?*
No
Yes
Are you currently using Retin-A, Renovaor Accutane?*
No
Yes
Have you used Retin-A, Renova or Accutane within the last 6 months?*
No
Yes
Are you using any skin thinning products and/or drugs that thin the blood?*
No
Yes
Are you exposed to the sun/tanning beds on a daily basis?*
No
Yes
Are you diabetic? (Being diabetic reduces the ability for the skin to heal.)*
No
Yes
Do you bruise easily?*
No
Yes
Do you have any allergies? (If you do not have allergies put N/A) If so please list:
Are you currently taking any medication? If no put N/A.) If so please list:
Do you give Rad Skin LLC permission to post photos on business social media accounts if asked?*
No
Yes
First Participant's Signature*
Second Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Information
How would you describe your gender identity? Check all that apply *
Female
Male
Transgender
Trans woman
Trans Man
Genderqueer
Genderfluid
Non-binary
Questioning
Other
What pronouns do you prefer?
Have you used Alpha Hydroxy Acid (AHA) or products containing glycolic within the last 48 hours?*
No
Yes
Are you currently using Retin-A, Renovaor Accutane?*
No
Yes
Have you used Retin-A, Renova or Accutane within the last 6 months?*
No
Yes
Are you using any skin thinning products and/or drugs that thin the blood?*
No
Yes
Are you exposed to the sun/tanning beds on a daily basis?*
No
Yes
Are you diabetic? (Being diabetic reduces the ability for the skin to heal.)*
No
Yes
Do you bruise easily?*
No
Yes
Do you have any allergies? (If you do not have allergies put N/A) If so please list:
Are you currently taking any medication? If no put N/A.) If so please list:
Do you give Rad Skin LLC permission to post photos on business social media accounts if asked?*
No
Yes
Third Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Information
How would you describe your gender identity? Check all that apply *
Female
Male
Transgender
Trans woman
Trans Man
Genderqueer
Genderfluid
Non-binary
Questioning
Other
What pronouns do you prefer?
Have you used Alpha Hydroxy Acid (AHA) or products containing glycolic within the last 48 hours?*
No
Yes
Are you currently using Retin-A, Renovaor Accutane?*
No
Yes
Have you used Retin-A, Renova or Accutane within the last 6 months?*
No
Yes
Are you using any skin thinning products and/or drugs that thin the blood?*
No
Yes
Are you exposed to the sun/tanning beds on a daily basis?*
No
Yes
Are you diabetic? (Being diabetic reduces the ability for the skin to heal.)*
No
Yes
Do you bruise easily?*
No
Yes
Do you have any allergies? (If you do not have allergies put N/A) If so please list:
Are you currently taking any medication? If no put N/A.) If so please list:
Do you give Rad Skin LLC permission to post photos on business social media accounts if asked?*
No
Yes
Fourth Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Information
How would you describe your gender identity? Check all that apply *
Female
Male
Transgender
Trans woman
Trans Man
Genderqueer
Genderfluid
Non-binary
Questioning
Other
What pronouns do you prefer?
Have you used Alpha Hydroxy Acid (AHA) or products containing glycolic within the last 48 hours?*
No
Yes
Are you currently using Retin-A, Renovaor Accutane?*
No
Yes
Have you used Retin-A, Renova or Accutane within the last 6 months?*
No
Yes
Are you using any skin thinning products and/or drugs that thin the blood?*
No
Yes
Are you exposed to the sun/tanning beds on a daily basis?*
No
Yes
Are you diabetic? (Being diabetic reduces the ability for the skin to heal.)*
No
Yes
Do you bruise easily?*
No
Yes
Do you have any allergies? (If you do not have allergies put N/A) If so please list:
Are you currently taking any medication? If no put N/A.) If so please list:
Do you give Rad Skin LLC permission to post photos on business social media accounts if asked?*
No
Yes
Fifth Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Information
How would you describe your gender identity? Check all that apply *
Female
Male
Transgender
Trans woman
Trans Man
Genderqueer
Genderfluid
Non-binary
Questioning
Other
What pronouns do you prefer?
Have you used Alpha Hydroxy Acid (AHA) or products containing glycolic within the last 48 hours?*
No
Yes
Are you currently using Retin-A, Renovaor Accutane?*
No
Yes
Have you used Retin-A, Renova or Accutane within the last 6 months?*
No
Yes
Are you using any skin thinning products and/or drugs that thin the blood?*
No
Yes
Are you exposed to the sun/tanning beds on a daily basis?*
No
Yes
Are you diabetic? (Being diabetic reduces the ability for the skin to heal.)*
No
Yes
Do you bruise easily?*
No
Yes
Do you have any allergies? (If you do not have allergies put N/A) If so please list:
Are you currently taking any medication? If no put N/A.) If so please list:
Do you give Rad Skin LLC permission to post photos on business social media accounts if asked?*
No
Yes
Sixth Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Information
How would you describe your gender identity? Check all that apply *
Female
Male
Transgender
Trans woman
Trans Man
Genderqueer
Genderfluid
Non-binary
Questioning
Other
What pronouns do you prefer?
Have you used Alpha Hydroxy Acid (AHA) or products containing glycolic within the last 48 hours?*
No
Yes
Are you currently using Retin-A, Renovaor Accutane?*
No
Yes
Have you used Retin-A, Renova or Accutane within the last 6 months?*
No
Yes
Are you using any skin thinning products and/or drugs that thin the blood?*
No
Yes
Are you exposed to the sun/tanning beds on a daily basis?*
No
Yes
Are you diabetic? (Being diabetic reduces the ability for the skin to heal.)*
No
Yes
Do you bruise easily?*
No
Yes
Do you have any allergies? (If you do not have allergies put N/A) If so please list:
Are you currently taking any medication? If no put N/A.) If so please list:
Do you give Rad Skin LLC permission to post photos on business social media accounts if asked?*
No
Yes
Seventh Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Information
How would you describe your gender identity? Check all that apply *
Female
Male
Transgender
Trans woman
Trans Man
Genderqueer
Genderfluid
Non-binary
Questioning
Other
What pronouns do you prefer?
Have you used Alpha Hydroxy Acid (AHA) or products containing glycolic within the last 48 hours?*
No
Yes
Are you currently using Retin-A, Renovaor Accutane?*
No
Yes
Have you used Retin-A, Renova or Accutane within the last 6 months?*
No
Yes
Are you using any skin thinning products and/or drugs that thin the blood?*
No
Yes
Are you exposed to the sun/tanning beds on a daily basis?*
No
Yes
Are you diabetic? (Being diabetic reduces the ability for the skin to heal.)*
No
Yes
Do you bruise easily?*
No
Yes
Do you have any allergies? (If you do not have allergies put N/A) If so please list:
Are you currently taking any medication? If no put N/A.) If so please list:
Do you give Rad Skin LLC permission to post photos on business social media accounts if asked?*
No
Yes
Eighth Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Information
How would you describe your gender identity? Check all that apply *
Female
Male
Transgender
Trans woman
Trans Man
Genderqueer
Genderfluid
Non-binary
Questioning
Other
What pronouns do you prefer?
Have you used Alpha Hydroxy Acid (AHA) or products containing glycolic within the last 48 hours?*
No
Yes
Are you currently using Retin-A, Renovaor Accutane?*
No
Yes
Have you used Retin-A, Renova or Accutane within the last 6 months?*
No
Yes
Are you using any skin thinning products and/or drugs that thin the blood?*
No
Yes
Are you exposed to the sun/tanning beds on a daily basis?*
No
Yes
Are you diabetic? (Being diabetic reduces the ability for the skin to heal.)*
No
Yes
Do you bruise easily?*
No
Yes
Do you have any allergies? (If you do not have allergies put N/A) If so please list:
Are you currently taking any medication? If no put N/A.) If so please list:
Do you give Rad Skin LLC permission to post photos on business social media accounts if asked?*
No
Yes
Ninth Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Information
How would you describe your gender identity? Check all that apply *
Female
Male
Transgender
Trans woman
Trans Man
Genderqueer
Genderfluid
Non-binary
Questioning
Other
What pronouns do you prefer?
Have you used Alpha Hydroxy Acid (AHA) or products containing glycolic within the last 48 hours?*
No
Yes
Are you currently using Retin-A, Renovaor Accutane?*
No
Yes
Have you used Retin-A, Renova or Accutane within the last 6 months?*
No
Yes
Are you using any skin thinning products and/or drugs that thin the blood?*
No
Yes
Are you exposed to the sun/tanning beds on a daily basis?*
No
Yes
Are you diabetic? (Being diabetic reduces the ability for the skin to heal.)*
No
Yes
Do you bruise easily?*
No
Yes
Do you have any allergies? (If you do not have allergies put N/A) If so please list:
Are you currently taking any medication? If no put N/A.) If so please list:
Do you give Rad Skin LLC permission to post photos on business social media accounts if asked?*
No
Yes
Tenth Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Information
How would you describe your gender identity? Check all that apply *
Female
Male
Transgender
Trans woman
Trans Man
Genderqueer
Genderfluid
Non-binary
Questioning
Other
What pronouns do you prefer?
Have you used Alpha Hydroxy Acid (AHA) or products containing glycolic within the last 48 hours?*
No
Yes
Are you currently using Retin-A, Renovaor Accutane?*
No
Yes
Have you used Retin-A, Renova or Accutane within the last 6 months?*
No
Yes
Are you using any skin thinning products and/or drugs that thin the blood?*
No
Yes
Are you exposed to the sun/tanning beds on a daily basis?*
No
Yes
Are you diabetic? (Being diabetic reduces the ability for the skin to heal.)*
No
Yes
Do you bruise easily?*
No
Yes
Do you have any allergies? (If you do not have allergies put N/A) If so please list:
Are you currently taking any medication? If no put N/A.) If so please list:
Do you give Rad Skin LLC permission to post photos on business social media accounts if asked?*
No
Yes
Participant's Address
Address Line 1:*
Street address, P.O. box, company name, c/o
Address Line 2:
Apartment, suite, unit, building, floor, etc.
Country:*
City:*
State/Province:*
Zip/Postal:*
Parent or Guardian's Email Address
Email*
Confirm Email*
Emergency Contact
First Name*
Last Name*
Emergency Contact's Phone Number*
Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.


By signing below the parent or court-appointed legal guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name
First Name*
Middle Name
Last Name*
Phone*
Parent or Guardian's Date of Birth*
Date of Birth
Information
How would you describe your gender identity? Check all that apply *
Female
Male
Transgender
Trans woman
Trans Man
Genderqueer
Genderfluid
Non-binary
Questioning
Other
What pronouns do you prefer?
Have you used Alpha Hydroxy Acid (AHA) or products containing glycolic within the last 48 hours?*
No
Yes
Are you currently using Retin-A, Renovaor Accutane?*
No
Yes
Have you used Retin-A, Renova or Accutane within the last 6 months?*
No
Yes
Are you using any skin thinning products and/or drugs that thin the blood?*
No
Yes
Are you exposed to the sun/tanning beds on a daily basis?*
No
Yes
Are you diabetic? (Being diabetic reduces the ability for the skin to heal.)*
No
Yes
Do you bruise easily?*
No
Yes
Do you have any allergies? (If you do not have allergies put N/A) If so please list:
Are you currently taking any medication? If no put N/A.) If so please list:
Do you give Rad Skin LLC permission to post photos on business social media accounts if asked?*
No
Yes
Parent or Guardian's Signature*
Electronic Signature Consent*
 By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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