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Bare & Beautiful Esthetics LLC

Consent Forms

(Please fill out the service or services portion that is applicable to you)

 

Bare & Beautiful Esthetics L.L.C.

CONSENT FORM 2025

 

 Cancellation policy:

Please reschedule or cancel 24 hours before your appointment oryou will be charged a cancellation fee of 50% for the entire service/services. You may cancel or reschedule your appointments via online, text or voicemail. 

I understand Bare & Beautiful Esthetic's cancellation policy and agree to pay the cancellation fee if I cancel/reschedule my appointment less than 24 hours noticed regardless of the reasons, I understand that my card is safe on file and will NOT be charged unless the cancellations criteria is not met. 


 

 

Waxing/Sugaring post care note:

FOLLOWING YOUR PROCEDURE:

I understand that following the sugaring wax/waxing procedure I should:

  • Apply sunblock with SPF of at least 30
  • Avoid using a loofah or other abrasive products to the waxed area
  • Avoid saunas, steam rooms, Jacuzzis or other heat sources
  • Avoid application of Retin-A, Renova, or AHA products for 48 hours

Please note that waxing has certain side effects such as skin removal, redness, swelling, tenderness, bleeding & brusing etc. If you have any concerns please address them with your specialist prior to treatment. If any reaction or unexpected skin condition should occur after the treatment (depending on the severity) I understand that the therapist who perform the service may not be able give certain after care suggestion in this care we will advise you to contact your physician. 

I understand if I have Herpes or Staph/MRSA I may experience an outbreak after the waxing/ sugaring service. I understand I may carry Herpes Staph/MRSA without any physical symptoms or a medical diagnosis. I also understand the waxing/sugaring services does not allow the contracting of these conditions for my technician. 

I understand all of the above mentioned reactions. I also understand if I change my skin care routine or medications I must inform my technician PRIOR to any future service 


 

 

 

 

 

 

 

First Client's Name
First Name*
Last Name*
Phone*
First Client's Date of Birth*
Date of Birth
First Client's Information
Who referred you today?

WAXING/SUGARING CONSENT FORM

Females clients: Are you currently Pregnant?*
No
Yes
Are you using AHA (Alpha Hydroxy Acid), Glycolic, Retin-a, Renova or Accutane (an oral form of Retin-a)?*
No
Yes
Are you using any blood/skin thinning products and/or drugs?*
No
Yes

MEDICAL DATA: 

Herpes Virus:*
No
Yes
Staph / MRSA:*
No
Yes
Have you ever had any adverse reactions to waxing/Sugaring?*
No
Yes

FACIAL /VAJACIAL CONSENT FORM 2025





Do you have any special skin problems or concerns?
Do you use Retin-A, Renova, or Retinol/vitamin A derivative products?*
No
Yes
Have you used any alpha-hydroxy acid or glycolic acid products in the last 48 hours?*
No
Yes
Are you currently taking Accutane or have you taken it in the past?*
No
Yes
How long ago?
Have you ever used Hydroquinone (skin lightener)?*
No
Yes
How long ago?
Have you used other acne medication?*
No
Yes
If yes, which one?
Any known allergies to skincare products or ingredients?*
No
Yes

WHAT SKIN CARE PRODUCTS ARE YOU CURRENTLY USING? PLEASE LIST THE BRAND IF KNOWN:

Cleanser & Toner (if any)
Exfoliation/Scrubs:
Treatment /Acne Product:
Moisturizer Day & Night
SPF:
PLEASE CHECK ANY AREAS OF CONCERN YOU HAVE REGARDING YOUR SKIN:
Acne
Blackheads
Whiteheads
Excessive Oil
Rosacea
Broken Capillaries
Redness
Uneven Skin Tone
Wrinkles
Sun Damage
Dull/Dry Skin
Flakey Skin
Dehydrated Skin
Sensitive Skin
Please Check any product(s) recommendation needed today?
Cleanser
Toner
Exfoliation
Serums
Moisturizer (AM/PM)
Sunscreen
Mask
Eye
Other:

HAVE YOU HAD ANY OF THE FOLLOWING:

Microdermabrasion?*
No
Yes
If so, when?
Chemical Peel?*
No
Yes
If so, when?
Laser Resurfacing?*
No
Yes
If so, when?
Collagen or Botox?*
No
Yes
If so, when?
Facial Surgery?*
No
Yes
If so, when?
Do you have permanent make up?*
No
Yes
If so, when?

LADIES ONLY:

Are you taking hormonal contraceptives?*
No
Yes
Are you pregnant or trying to become pregnant?*
No
Yes
Are you nursing?*
No
Yes
Experiencing any hormone/menopause problems?*
No
Yes

I hereby consent to and authorize Bare & Beautiful Esthetics LLC

to perform the following procedure:

Type of Facial: (write none if not receiving facial today)

Although it is impossible to list every potential risk and complication, I have been informed of possible benefits, risks, and complications. I also recognize there are no guaranteed results and that independent results are dependent upon age, skin condition, and lifestyle and that there is the possibility I may require further treatments of the treated areas to obtain the expected results at an additional cost. In the event that I may have additional questions or concerns regarding my treatment or suggested home product/ post-treatment care, I will consult with my esthetician immediately. I have also, to the best of my knowledge, given an accurate account of my medical history, including all known allergies or prescription drugs or products I am currently ingesting or using topically. I have read and fully understand this agreement and all information detailed above. I understand the procedure and accept the risks. All of my questions have been answered to my satisfaction and I consent to the terms of this agreement. I do not hold the esthetician responsible for any of my conditions that were present, and or was not disclosed at the time of this skin care procedure, which may be affected by the treatment performed today.

I understand facial packages are non-refundable under any circumstances! If you are not able to receive facials any longer you many use credit towards products or other services. 

Bare & Beautiful Esthetics offers product samples (try before you buy) therefore, I understand that all products purchased are non refundable this is also for safety purposes. 

I understand in the event if any major skin reaction that occurs certain support or after care may not be provided/suggested by the service provider (for safety reasons) instead you will need to contact your physician immediately. 







First Client's Signature*
Second Client's Name
First Name*
Last Name*
Client's Date of Birth*
Date of Birth
Second Client's Information
Who referred you today?

WAXING/SUGARING CONSENT FORM

Females clients: Are you currently Pregnant?*
No
Yes
Are you using AHA (Alpha Hydroxy Acid), Glycolic, Retin-a, Renova or Accutane (an oral form of Retin-a)?*
No
Yes
Are you using any blood/skin thinning products and/or drugs?*
No
Yes

MEDICAL DATA: 

Herpes Virus:*
No
Yes
Staph / MRSA:*
No
Yes
Have you ever had any adverse reactions to waxing/Sugaring?*
No
Yes

FACIAL /VAJACIAL CONSENT FORM 2025





Do you have any special skin problems or concerns?
Do you use Retin-A, Renova, or Retinol/vitamin A derivative products?*
No
Yes
Have you used any alpha-hydroxy acid or glycolic acid products in the last 48 hours?*
No
Yes
Are you currently taking Accutane or have you taken it in the past?*
No
Yes
How long ago?
Have you ever used Hydroquinone (skin lightener)?*
No
Yes
How long ago?
Have you used other acne medication?*
No
Yes
If yes, which one?
Any known allergies to skincare products or ingredients?*
No
Yes

WHAT SKIN CARE PRODUCTS ARE YOU CURRENTLY USING? PLEASE LIST THE BRAND IF KNOWN:

Cleanser & Toner (if any)
Exfoliation/Scrubs:
Treatment /Acne Product:
Moisturizer Day & Night
SPF:
PLEASE CHECK ANY AREAS OF CONCERN YOU HAVE REGARDING YOUR SKIN:
Acne
Blackheads
Whiteheads
Excessive Oil
Rosacea
Broken Capillaries
Redness
Uneven Skin Tone
Wrinkles
Sun Damage
Dull/Dry Skin
Flakey Skin
Dehydrated Skin
Sensitive Skin
Please Check any product(s) recommendation needed today?
Cleanser
Toner
Exfoliation
Serums
Moisturizer (AM/PM)
Sunscreen
Mask
Eye
Other:

HAVE YOU HAD ANY OF THE FOLLOWING:

Microdermabrasion?*
No
Yes
If so, when?
Chemical Peel?*
No
Yes
If so, when?
Laser Resurfacing?*
No
Yes
If so, when?
Collagen or Botox?*
No
Yes
If so, when?
Facial Surgery?*
No
Yes
If so, when?
Do you have permanent make up?*
No
Yes
If so, when?

LADIES ONLY:

Are you taking hormonal contraceptives?*
No
Yes
Are you pregnant or trying to become pregnant?*
No
Yes
Are you nursing?*
No
Yes
Experiencing any hormone/menopause problems?*
No
Yes

I hereby consent to and authorize Bare & Beautiful Esthetics LLC

to perform the following procedure:

Type of Facial: (write none if not receiving facial today)

Although it is impossible to list every potential risk and complication, I have been informed of possible benefits, risks, and complications. I also recognize there are no guaranteed results and that independent results are dependent upon age, skin condition, and lifestyle and that there is the possibility I may require further treatments of the treated areas to obtain the expected results at an additional cost. In the event that I may have additional questions or concerns regarding my treatment or suggested home product/ post-treatment care, I will consult with my esthetician immediately. I have also, to the best of my knowledge, given an accurate account of my medical history, including all known allergies or prescription drugs or products I am currently ingesting or using topically. I have read and fully understand this agreement and all information detailed above. I understand the procedure and accept the risks. All of my questions have been answered to my satisfaction and I consent to the terms of this agreement. I do not hold the esthetician responsible for any of my conditions that were present, and or was not disclosed at the time of this skin care procedure, which may be affected by the treatment performed today.

I understand facial packages are non-refundable under any circumstances! If you are not able to receive facials any longer you many use credit towards products or other services. 

Bare & Beautiful Esthetics offers product samples (try before you buy) therefore, I understand that all products purchased are non refundable this is also for safety purposes. 

I understand in the event if any major skin reaction that occurs certain support or after care may not be provided/suggested by the service provider (for safety reasons) instead you will need to contact your physician immediately. 







Third Client's Name
First Name*
Last Name*
Client's Date of Birth*
Date of Birth
Third Client's Information
Who referred you today?

WAXING/SUGARING CONSENT FORM

Females clients: Are you currently Pregnant?*
No
Yes
Are you using AHA (Alpha Hydroxy Acid), Glycolic, Retin-a, Renova or Accutane (an oral form of Retin-a)?*
No
Yes
Are you using any blood/skin thinning products and/or drugs?*
No
Yes

MEDICAL DATA: 

Herpes Virus:*
No
Yes
Staph / MRSA:*
No
Yes
Have you ever had any adverse reactions to waxing/Sugaring?*
No
Yes

FACIAL /VAJACIAL CONSENT FORM 2025





Do you have any special skin problems or concerns?
Do you use Retin-A, Renova, or Retinol/vitamin A derivative products?*
No
Yes
Have you used any alpha-hydroxy acid or glycolic acid products in the last 48 hours?*
No
Yes
Are you currently taking Accutane or have you taken it in the past?*
No
Yes
How long ago?
Have you ever used Hydroquinone (skin lightener)?*
No
Yes
How long ago?
Have you used other acne medication?*
No
Yes
If yes, which one?
Any known allergies to skincare products or ingredients?*
No
Yes

WHAT SKIN CARE PRODUCTS ARE YOU CURRENTLY USING? PLEASE LIST THE BRAND IF KNOWN:

Cleanser & Toner (if any)
Exfoliation/Scrubs:
Treatment /Acne Product:
Moisturizer Day & Night
SPF:
PLEASE CHECK ANY AREAS OF CONCERN YOU HAVE REGARDING YOUR SKIN:
Acne
Blackheads
Whiteheads
Excessive Oil
Rosacea
Broken Capillaries
Redness
Uneven Skin Tone
Wrinkles
Sun Damage
Dull/Dry Skin
Flakey Skin
Dehydrated Skin
Sensitive Skin
Please Check any product(s) recommendation needed today?
Cleanser
Toner
Exfoliation
Serums
Moisturizer (AM/PM)
Sunscreen
Mask
Eye
Other:

HAVE YOU HAD ANY OF THE FOLLOWING:

Microdermabrasion?*
No
Yes
If so, when?
Chemical Peel?*
No
Yes
If so, when?
Laser Resurfacing?*
No
Yes
If so, when?
Collagen or Botox?*
No
Yes
If so, when?
Facial Surgery?*
No
Yes
If so, when?
Do you have permanent make up?*
No
Yes
If so, when?

LADIES ONLY:

Are you taking hormonal contraceptives?*
No
Yes
Are you pregnant or trying to become pregnant?*
No
Yes
Are you nursing?*
No
Yes
Experiencing any hormone/menopause problems?*
No
Yes

I hereby consent to and authorize Bare & Beautiful Esthetics LLC

to perform the following procedure:

Type of Facial: (write none if not receiving facial today)

Although it is impossible to list every potential risk and complication, I have been informed of possible benefits, risks, and complications. I also recognize there are no guaranteed results and that independent results are dependent upon age, skin condition, and lifestyle and that there is the possibility I may require further treatments of the treated areas to obtain the expected results at an additional cost. In the event that I may have additional questions or concerns regarding my treatment or suggested home product/ post-treatment care, I will consult with my esthetician immediately. I have also, to the best of my knowledge, given an accurate account of my medical history, including all known allergies or prescription drugs or products I am currently ingesting or using topically. I have read and fully understand this agreement and all information detailed above. I understand the procedure and accept the risks. All of my questions have been answered to my satisfaction and I consent to the terms of this agreement. I do not hold the esthetician responsible for any of my conditions that were present, and or was not disclosed at the time of this skin care procedure, which may be affected by the treatment performed today.

I understand facial packages are non-refundable under any circumstances! If you are not able to receive facials any longer you many use credit towards products or other services. 

Bare & Beautiful Esthetics offers product samples (try before you buy) therefore, I understand that all products purchased are non refundable this is also for safety purposes. 

I understand in the event if any major skin reaction that occurs certain support or after care may not be provided/suggested by the service provider (for safety reasons) instead you will need to contact your physician immediately. 







Fourth Client's Name
First Name*
Last Name*
Client's Date of Birth*
Date of Birth
Fourth Client's Information
Who referred you today?

WAXING/SUGARING CONSENT FORM

Females clients: Are you currently Pregnant?*
No
Yes
Are you using AHA (Alpha Hydroxy Acid), Glycolic, Retin-a, Renova or Accutane (an oral form of Retin-a)?*
No
Yes
Are you using any blood/skin thinning products and/or drugs?*
No
Yes

MEDICAL DATA: 

Herpes Virus:*
No
Yes
Staph / MRSA:*
No
Yes
Have you ever had any adverse reactions to waxing/Sugaring?*
No
Yes

FACIAL /VAJACIAL CONSENT FORM 2025





Do you have any special skin problems or concerns?
Do you use Retin-A, Renova, or Retinol/vitamin A derivative products?*
No
Yes
Have you used any alpha-hydroxy acid or glycolic acid products in the last 48 hours?*
No
Yes
Are you currently taking Accutane or have you taken it in the past?*
No
Yes
How long ago?
Have you ever used Hydroquinone (skin lightener)?*
No
Yes
How long ago?
Have you used other acne medication?*
No
Yes
If yes, which one?
Any known allergies to skincare products or ingredients?*
No
Yes

WHAT SKIN CARE PRODUCTS ARE YOU CURRENTLY USING? PLEASE LIST THE BRAND IF KNOWN:

Cleanser & Toner (if any)
Exfoliation/Scrubs:
Treatment /Acne Product:
Moisturizer Day & Night
SPF:
PLEASE CHECK ANY AREAS OF CONCERN YOU HAVE REGARDING YOUR SKIN:
Acne
Blackheads
Whiteheads
Excessive Oil
Rosacea
Broken Capillaries
Redness
Uneven Skin Tone
Wrinkles
Sun Damage
Dull/Dry Skin
Flakey Skin
Dehydrated Skin
Sensitive Skin
Please Check any product(s) recommendation needed today?
Cleanser
Toner
Exfoliation
Serums
Moisturizer (AM/PM)
Sunscreen
Mask
Eye
Other:

HAVE YOU HAD ANY OF THE FOLLOWING:

Microdermabrasion?*
No
Yes
If so, when?
Chemical Peel?*
No
Yes
If so, when?
Laser Resurfacing?*
No
Yes
If so, when?
Collagen or Botox?*
No
Yes
If so, when?
Facial Surgery?*
No
Yes
If so, when?
Do you have permanent make up?*
No
Yes
If so, when?

LADIES ONLY:

Are you taking hormonal contraceptives?*
No
Yes
Are you pregnant or trying to become pregnant?*
No
Yes
Are you nursing?*
No
Yes
Experiencing any hormone/menopause problems?*
No
Yes

I hereby consent to and authorize Bare & Beautiful Esthetics LLC

to perform the following procedure:

Type of Facial: (write none if not receiving facial today)

Although it is impossible to list every potential risk and complication, I have been informed of possible benefits, risks, and complications. I also recognize there are no guaranteed results and that independent results are dependent upon age, skin condition, and lifestyle and that there is the possibility I may require further treatments of the treated areas to obtain the expected results at an additional cost. In the event that I may have additional questions or concerns regarding my treatment or suggested home product/ post-treatment care, I will consult with my esthetician immediately. I have also, to the best of my knowledge, given an accurate account of my medical history, including all known allergies or prescription drugs or products I am currently ingesting or using topically. I have read and fully understand this agreement and all information detailed above. I understand the procedure and accept the risks. All of my questions have been answered to my satisfaction and I consent to the terms of this agreement. I do not hold the esthetician responsible for any of my conditions that were present, and or was not disclosed at the time of this skin care procedure, which may be affected by the treatment performed today.

I understand facial packages are non-refundable under any circumstances! If you are not able to receive facials any longer you many use credit towards products or other services. 

Bare & Beautiful Esthetics offers product samples (try before you buy) therefore, I understand that all products purchased are non refundable this is also for safety purposes. 

I understand in the event if any major skin reaction that occurs certain support or after care may not be provided/suggested by the service provider (for safety reasons) instead you will need to contact your physician immediately. 







Fifth Client's Name
First Name*
Last Name*
Client's Date of Birth*
Date of Birth
Fifth Client's Information
Who referred you today?

WAXING/SUGARING CONSENT FORM

Females clients: Are you currently Pregnant?*
No
Yes
Are you using AHA (Alpha Hydroxy Acid), Glycolic, Retin-a, Renova or Accutane (an oral form of Retin-a)?*
No
Yes
Are you using any blood/skin thinning products and/or drugs?*
No
Yes

MEDICAL DATA: 

Herpes Virus:*
No
Yes
Staph / MRSA:*
No
Yes
Have you ever had any adverse reactions to waxing/Sugaring?*
No
Yes

FACIAL /VAJACIAL CONSENT FORM 2025





Do you have any special skin problems or concerns?
Do you use Retin-A, Renova, or Retinol/vitamin A derivative products?*
No
Yes
Have you used any alpha-hydroxy acid or glycolic acid products in the last 48 hours?*
No
Yes
Are you currently taking Accutane or have you taken it in the past?*
No
Yes
How long ago?
Have you ever used Hydroquinone (skin lightener)?*
No
Yes
How long ago?
Have you used other acne medication?*
No
Yes
If yes, which one?
Any known allergies to skincare products or ingredients?*
No
Yes

WHAT SKIN CARE PRODUCTS ARE YOU CURRENTLY USING? PLEASE LIST THE BRAND IF KNOWN:

Cleanser & Toner (if any)
Exfoliation/Scrubs:
Treatment /Acne Product:
Moisturizer Day & Night
SPF:
PLEASE CHECK ANY AREAS OF CONCERN YOU HAVE REGARDING YOUR SKIN:
Acne
Blackheads
Whiteheads
Excessive Oil
Rosacea
Broken Capillaries
Redness
Uneven Skin Tone
Wrinkles
Sun Damage
Dull/Dry Skin
Flakey Skin
Dehydrated Skin
Sensitive Skin
Please Check any product(s) recommendation needed today?
Cleanser
Toner
Exfoliation
Serums
Moisturizer (AM/PM)
Sunscreen
Mask
Eye
Other:

HAVE YOU HAD ANY OF THE FOLLOWING:

Microdermabrasion?*
No
Yes
If so, when?
Chemical Peel?*
No
Yes
If so, when?
Laser Resurfacing?*
No
Yes
If so, when?
Collagen or Botox?*
No
Yes
If so, when?
Facial Surgery?*
No
Yes
If so, when?
Do you have permanent make up?*
No
Yes
If so, when?

LADIES ONLY:

Are you taking hormonal contraceptives?*
No
Yes
Are you pregnant or trying to become pregnant?*
No
Yes
Are you nursing?*
No
Yes
Experiencing any hormone/menopause problems?*
No
Yes

I hereby consent to and authorize Bare & Beautiful Esthetics LLC

to perform the following procedure:

Type of Facial: (write none if not receiving facial today)

Although it is impossible to list every potential risk and complication, I have been informed of possible benefits, risks, and complications. I also recognize there are no guaranteed results and that independent results are dependent upon age, skin condition, and lifestyle and that there is the possibility I may require further treatments of the treated areas to obtain the expected results at an additional cost. In the event that I may have additional questions or concerns regarding my treatment or suggested home product/ post-treatment care, I will consult with my esthetician immediately. I have also, to the best of my knowledge, given an accurate account of my medical history, including all known allergies or prescription drugs or products I am currently ingesting or using topically. I have read and fully understand this agreement and all information detailed above. I understand the procedure and accept the risks. All of my questions have been answered to my satisfaction and I consent to the terms of this agreement. I do not hold the esthetician responsible for any of my conditions that were present, and or was not disclosed at the time of this skin care procedure, which may be affected by the treatment performed today.

I understand facial packages are non-refundable under any circumstances! If you are not able to receive facials any longer you many use credit towards products or other services. 

Bare & Beautiful Esthetics offers product samples (try before you buy) therefore, I understand that all products purchased are non refundable this is also for safety purposes. 

I understand in the event if any major skin reaction that occurs certain support or after care may not be provided/suggested by the service provider (for safety reasons) instead you will need to contact your physician immediately. 







Sixth Client's Name
First Name*
Last Name*
Client's Date of Birth*
Date of Birth
Sixth Client's Information
Who referred you today?

WAXING/SUGARING CONSENT FORM

Females clients: Are you currently Pregnant?*
No
Yes
Are you using AHA (Alpha Hydroxy Acid), Glycolic, Retin-a, Renova or Accutane (an oral form of Retin-a)?*
No
Yes
Are you using any blood/skin thinning products and/or drugs?*
No
Yes

MEDICAL DATA: 

Herpes Virus:*
No
Yes
Staph / MRSA:*
No
Yes
Have you ever had any adverse reactions to waxing/Sugaring?*
No
Yes

FACIAL /VAJACIAL CONSENT FORM 2025





Do you have any special skin problems or concerns?
Do you use Retin-A, Renova, or Retinol/vitamin A derivative products?*
No
Yes
Have you used any alpha-hydroxy acid or glycolic acid products in the last 48 hours?*
No
Yes
Are you currently taking Accutane or have you taken it in the past?*
No
Yes
How long ago?
Have you ever used Hydroquinone (skin lightener)?*
No
Yes
How long ago?
Have you used other acne medication?*
No
Yes
If yes, which one?
Any known allergies to skincare products or ingredients?*
No
Yes

WHAT SKIN CARE PRODUCTS ARE YOU CURRENTLY USING? PLEASE LIST THE BRAND IF KNOWN:

Cleanser & Toner (if any)
Exfoliation/Scrubs:
Treatment /Acne Product:
Moisturizer Day & Night
SPF:
PLEASE CHECK ANY AREAS OF CONCERN YOU HAVE REGARDING YOUR SKIN:
Acne
Blackheads
Whiteheads
Excessive Oil
Rosacea
Broken Capillaries
Redness
Uneven Skin Tone
Wrinkles
Sun Damage
Dull/Dry Skin
Flakey Skin
Dehydrated Skin
Sensitive Skin
Please Check any product(s) recommendation needed today?
Cleanser
Toner
Exfoliation
Serums
Moisturizer (AM/PM)
Sunscreen
Mask
Eye
Other:

HAVE YOU HAD ANY OF THE FOLLOWING:

Microdermabrasion?*
No
Yes
If so, when?
Chemical Peel?*
No
Yes
If so, when?
Laser Resurfacing?*
No
Yes
If so, when?
Collagen or Botox?*
No
Yes
If so, when?
Facial Surgery?*
No
Yes
If so, when?
Do you have permanent make up?*
No
Yes
If so, when?

LADIES ONLY:

Are you taking hormonal contraceptives?*
No
Yes
Are you pregnant or trying to become pregnant?*
No
Yes
Are you nursing?*
No
Yes
Experiencing any hormone/menopause problems?*
No
Yes

I hereby consent to and authorize Bare & Beautiful Esthetics LLC

to perform the following procedure:

Type of Facial: (write none if not receiving facial today)

Although it is impossible to list every potential risk and complication, I have been informed of possible benefits, risks, and complications. I also recognize there are no guaranteed results and that independent results are dependent upon age, skin condition, and lifestyle and that there is the possibility I may require further treatments of the treated areas to obtain the expected results at an additional cost. In the event that I may have additional questions or concerns regarding my treatment or suggested home product/ post-treatment care, I will consult with my esthetician immediately. I have also, to the best of my knowledge, given an accurate account of my medical history, including all known allergies or prescription drugs or products I am currently ingesting or using topically. I have read and fully understand this agreement and all information detailed above. I understand the procedure and accept the risks. All of my questions have been answered to my satisfaction and I consent to the terms of this agreement. I do not hold the esthetician responsible for any of my conditions that were present, and or was not disclosed at the time of this skin care procedure, which may be affected by the treatment performed today.

I understand facial packages are non-refundable under any circumstances! If you are not able to receive facials any longer you many use credit towards products or other services. 

Bare & Beautiful Esthetics offers product samples (try before you buy) therefore, I understand that all products purchased are non refundable this is also for safety purposes. 

I understand in the event if any major skin reaction that occurs certain support or after care may not be provided/suggested by the service provider (for safety reasons) instead you will need to contact your physician immediately. 







Seventh Client's Name
First Name*
Last Name*
Client's Date of Birth*
Date of Birth
Seventh Client's Information
Who referred you today?

WAXING/SUGARING CONSENT FORM

Females clients: Are you currently Pregnant?*
No
Yes
Are you using AHA (Alpha Hydroxy Acid), Glycolic, Retin-a, Renova or Accutane (an oral form of Retin-a)?*
No
Yes
Are you using any blood/skin thinning products and/or drugs?*
No
Yes

MEDICAL DATA: 

Herpes Virus:*
No
Yes
Staph / MRSA:*
No
Yes
Have you ever had any adverse reactions to waxing/Sugaring?*
No
Yes

FACIAL /VAJACIAL CONSENT FORM 2025





Do you have any special skin problems or concerns?
Do you use Retin-A, Renova, or Retinol/vitamin A derivative products?*
No
Yes
Have you used any alpha-hydroxy acid or glycolic acid products in the last 48 hours?*
No
Yes
Are you currently taking Accutane or have you taken it in the past?*
No
Yes
How long ago?
Have you ever used Hydroquinone (skin lightener)?*
No
Yes
How long ago?
Have you used other acne medication?*
No
Yes
If yes, which one?
Any known allergies to skincare products or ingredients?*
No
Yes

WHAT SKIN CARE PRODUCTS ARE YOU CURRENTLY USING? PLEASE LIST THE BRAND IF KNOWN:

Cleanser & Toner (if any)
Exfoliation/Scrubs:
Treatment /Acne Product:
Moisturizer Day & Night
SPF:
PLEASE CHECK ANY AREAS OF CONCERN YOU HAVE REGARDING YOUR SKIN:
Acne
Blackheads
Whiteheads
Excessive Oil
Rosacea
Broken Capillaries
Redness
Uneven Skin Tone
Wrinkles
Sun Damage
Dull/Dry Skin
Flakey Skin
Dehydrated Skin
Sensitive Skin
Please Check any product(s) recommendation needed today?
Cleanser
Toner
Exfoliation
Serums
Moisturizer (AM/PM)
Sunscreen
Mask
Eye
Other:

HAVE YOU HAD ANY OF THE FOLLOWING:

Microdermabrasion?*
No
Yes
If so, when?
Chemical Peel?*
No
Yes
If so, when?
Laser Resurfacing?*
No
Yes
If so, when?
Collagen or Botox?*
No
Yes
If so, when?
Facial Surgery?*
No
Yes
If so, when?
Do you have permanent make up?*
No
Yes
If so, when?

LADIES ONLY:

Are you taking hormonal contraceptives?*
No
Yes
Are you pregnant or trying to become pregnant?*
No
Yes
Are you nursing?*
No
Yes
Experiencing any hormone/menopause problems?*
No
Yes

I hereby consent to and authorize Bare & Beautiful Esthetics LLC

to perform the following procedure:

Type of Facial: (write none if not receiving facial today)

Although it is impossible to list every potential risk and complication, I have been informed of possible benefits, risks, and complications. I also recognize there are no guaranteed results and that independent results are dependent upon age, skin condition, and lifestyle and that there is the possibility I may require further treatments of the treated areas to obtain the expected results at an additional cost. In the event that I may have additional questions or concerns regarding my treatment or suggested home product/ post-treatment care, I will consult with my esthetician immediately. I have also, to the best of my knowledge, given an accurate account of my medical history, including all known allergies or prescription drugs or products I am currently ingesting or using topically. I have read and fully understand this agreement and all information detailed above. I understand the procedure and accept the risks. All of my questions have been answered to my satisfaction and I consent to the terms of this agreement. I do not hold the esthetician responsible for any of my conditions that were present, and or was not disclosed at the time of this skin care procedure, which may be affected by the treatment performed today.

I understand facial packages are non-refundable under any circumstances! If you are not able to receive facials any longer you many use credit towards products or other services. 

Bare & Beautiful Esthetics offers product samples (try before you buy) therefore, I understand that all products purchased are non refundable this is also for safety purposes. 

I understand in the event if any major skin reaction that occurs certain support or after care may not be provided/suggested by the service provider (for safety reasons) instead you will need to contact your physician immediately. 







Eighth Client's Name
First Name*
Last Name*
Client's Date of Birth*
Date of Birth
Eighth Client's Information
Who referred you today?

WAXING/SUGARING CONSENT FORM

Females clients: Are you currently Pregnant?*
No
Yes
Are you using AHA (Alpha Hydroxy Acid), Glycolic, Retin-a, Renova or Accutane (an oral form of Retin-a)?*
No
Yes
Are you using any blood/skin thinning products and/or drugs?*
No
Yes

MEDICAL DATA: 

Herpes Virus:*
No
Yes
Staph / MRSA:*
No
Yes
Have you ever had any adverse reactions to waxing/Sugaring?*
No
Yes

FACIAL /VAJACIAL CONSENT FORM 2025





Do you have any special skin problems or concerns?
Do you use Retin-A, Renova, or Retinol/vitamin A derivative products?*
No
Yes
Have you used any alpha-hydroxy acid or glycolic acid products in the last 48 hours?*
No
Yes
Are you currently taking Accutane or have you taken it in the past?*
No
Yes
How long ago?
Have you ever used Hydroquinone (skin lightener)?*
No
Yes
How long ago?
Have you used other acne medication?*
No
Yes
If yes, which one?
Any known allergies to skincare products or ingredients?*
No
Yes

WHAT SKIN CARE PRODUCTS ARE YOU CURRENTLY USING? PLEASE LIST THE BRAND IF KNOWN:

Cleanser & Toner (if any)
Exfoliation/Scrubs:
Treatment /Acne Product:
Moisturizer Day & Night
SPF:
PLEASE CHECK ANY AREAS OF CONCERN YOU HAVE REGARDING YOUR SKIN:
Acne
Blackheads
Whiteheads
Excessive Oil
Rosacea
Broken Capillaries
Redness
Uneven Skin Tone
Wrinkles
Sun Damage
Dull/Dry Skin
Flakey Skin
Dehydrated Skin
Sensitive Skin
Please Check any product(s) recommendation needed today?
Cleanser
Toner
Exfoliation
Serums
Moisturizer (AM/PM)
Sunscreen
Mask
Eye
Other:

HAVE YOU HAD ANY OF THE FOLLOWING:

Microdermabrasion?*
No
Yes
If so, when?
Chemical Peel?*
No
Yes
If so, when?
Laser Resurfacing?*
No
Yes
If so, when?
Collagen or Botox?*
No
Yes
If so, when?
Facial Surgery?*
No
Yes
If so, when?
Do you have permanent make up?*
No
Yes
If so, when?

LADIES ONLY:

Are you taking hormonal contraceptives?*
No
Yes
Are you pregnant or trying to become pregnant?*
No
Yes
Are you nursing?*
No
Yes
Experiencing any hormone/menopause problems?*
No
Yes

I hereby consent to and authorize Bare & Beautiful Esthetics LLC

to perform the following procedure:

Type of Facial: (write none if not receiving facial today)

Although it is impossible to list every potential risk and complication, I have been informed of possible benefits, risks, and complications. I also recognize there are no guaranteed results and that independent results are dependent upon age, skin condition, and lifestyle and that there is the possibility I may require further treatments of the treated areas to obtain the expected results at an additional cost. In the event that I may have additional questions or concerns regarding my treatment or suggested home product/ post-treatment care, I will consult with my esthetician immediately. I have also, to the best of my knowledge, given an accurate account of my medical history, including all known allergies or prescription drugs or products I am currently ingesting or using topically. I have read and fully understand this agreement and all information detailed above. I understand the procedure and accept the risks. All of my questions have been answered to my satisfaction and I consent to the terms of this agreement. I do not hold the esthetician responsible for any of my conditions that were present, and or was not disclosed at the time of this skin care procedure, which may be affected by the treatment performed today.

I understand facial packages are non-refundable under any circumstances! If you are not able to receive facials any longer you many use credit towards products or other services. 

Bare & Beautiful Esthetics offers product samples (try before you buy) therefore, I understand that all products purchased are non refundable this is also for safety purposes. 

I understand in the event if any major skin reaction that occurs certain support or after care may not be provided/suggested by the service provider (for safety reasons) instead you will need to contact your physician immediately. 







Ninth Client's Name
First Name*
Last Name*
Client's Date of Birth*
Date of Birth
Ninth Client's Information
Who referred you today?

WAXING/SUGARING CONSENT FORM

Females clients: Are you currently Pregnant?*
No
Yes
Are you using AHA (Alpha Hydroxy Acid), Glycolic, Retin-a, Renova or Accutane (an oral form of Retin-a)?*
No
Yes
Are you using any blood/skin thinning products and/or drugs?*
No
Yes

MEDICAL DATA: 

Herpes Virus:*
No
Yes
Staph / MRSA:*
No
Yes
Have you ever had any adverse reactions to waxing/Sugaring?*
No
Yes

FACIAL /VAJACIAL CONSENT FORM 2025





Do you have any special skin problems or concerns?
Do you use Retin-A, Renova, or Retinol/vitamin A derivative products?*
No
Yes
Have you used any alpha-hydroxy acid or glycolic acid products in the last 48 hours?*
No
Yes
Are you currently taking Accutane or have you taken it in the past?*
No
Yes
How long ago?
Have you ever used Hydroquinone (skin lightener)?*
No
Yes
How long ago?
Have you used other acne medication?*
No
Yes
If yes, which one?
Any known allergies to skincare products or ingredients?*
No
Yes

WHAT SKIN CARE PRODUCTS ARE YOU CURRENTLY USING? PLEASE LIST THE BRAND IF KNOWN:

Cleanser & Toner (if any)
Exfoliation/Scrubs:
Treatment /Acne Product:
Moisturizer Day & Night
SPF:
PLEASE CHECK ANY AREAS OF CONCERN YOU HAVE REGARDING YOUR SKIN:
Acne
Blackheads
Whiteheads
Excessive Oil
Rosacea
Broken Capillaries
Redness
Uneven Skin Tone
Wrinkles
Sun Damage
Dull/Dry Skin
Flakey Skin
Dehydrated Skin
Sensitive Skin
Please Check any product(s) recommendation needed today?
Cleanser
Toner
Exfoliation
Serums
Moisturizer (AM/PM)
Sunscreen
Mask
Eye
Other:

HAVE YOU HAD ANY OF THE FOLLOWING:

Microdermabrasion?*
No
Yes
If so, when?
Chemical Peel?*
No
Yes
If so, when?
Laser Resurfacing?*
No
Yes
If so, when?
Collagen or Botox?*
No
Yes
If so, when?
Facial Surgery?*
No
Yes
If so, when?
Do you have permanent make up?*
No
Yes
If so, when?

LADIES ONLY:

Are you taking hormonal contraceptives?*
No
Yes
Are you pregnant or trying to become pregnant?*
No
Yes
Are you nursing?*
No
Yes
Experiencing any hormone/menopause problems?*
No
Yes

I hereby consent to and authorize Bare & Beautiful Esthetics LLC

to perform the following procedure:

Type of Facial: (write none if not receiving facial today)

Although it is impossible to list every potential risk and complication, I have been informed of possible benefits, risks, and complications. I also recognize there are no guaranteed results and that independent results are dependent upon age, skin condition, and lifestyle and that there is the possibility I may require further treatments of the treated areas to obtain the expected results at an additional cost. In the event that I may have additional questions or concerns regarding my treatment or suggested home product/ post-treatment care, I will consult with my esthetician immediately. I have also, to the best of my knowledge, given an accurate account of my medical history, including all known allergies or prescription drugs or products I am currently ingesting or using topically. I have read and fully understand this agreement and all information detailed above. I understand the procedure and accept the risks. All of my questions have been answered to my satisfaction and I consent to the terms of this agreement. I do not hold the esthetician responsible for any of my conditions that were present, and or was not disclosed at the time of this skin care procedure, which may be affected by the treatment performed today.

I understand facial packages are non-refundable under any circumstances! If you are not able to receive facials any longer you many use credit towards products or other services. 

Bare & Beautiful Esthetics offers product samples (try before you buy) therefore, I understand that all products purchased are non refundable this is also for safety purposes. 

I understand in the event if any major skin reaction that occurs certain support or after care may not be provided/suggested by the service provider (for safety reasons) instead you will need to contact your physician immediately. 







Tenth Client's Name
First Name*
Last Name*
Client's Date of Birth*
Date of Birth
Tenth Client's Information
Who referred you today?

WAXING/SUGARING CONSENT FORM

Females clients: Are you currently Pregnant?*
No
Yes
Are you using AHA (Alpha Hydroxy Acid), Glycolic, Retin-a, Renova or Accutane (an oral form of Retin-a)?*
No
Yes
Are you using any blood/skin thinning products and/or drugs?*
No
Yes

MEDICAL DATA: 

Herpes Virus:*
No
Yes
Staph / MRSA:*
No
Yes
Have you ever had any adverse reactions to waxing/Sugaring?*
No
Yes

FACIAL /VAJACIAL CONSENT FORM 2025





Do you have any special skin problems or concerns?
Do you use Retin-A, Renova, or Retinol/vitamin A derivative products?*
No
Yes
Have you used any alpha-hydroxy acid or glycolic acid products in the last 48 hours?*
No
Yes
Are you currently taking Accutane or have you taken it in the past?*
No
Yes
How long ago?
Have you ever used Hydroquinone (skin lightener)?*
No
Yes
How long ago?
Have you used other acne medication?*
No
Yes
If yes, which one?
Any known allergies to skincare products or ingredients?*
No
Yes

WHAT SKIN CARE PRODUCTS ARE YOU CURRENTLY USING? PLEASE LIST THE BRAND IF KNOWN:

Cleanser & Toner (if any)
Exfoliation/Scrubs:
Treatment /Acne Product:
Moisturizer Day & Night
SPF:
PLEASE CHECK ANY AREAS OF CONCERN YOU HAVE REGARDING YOUR SKIN:
Acne
Blackheads
Whiteheads
Excessive Oil
Rosacea
Broken Capillaries
Redness
Uneven Skin Tone
Wrinkles
Sun Damage
Dull/Dry Skin
Flakey Skin
Dehydrated Skin
Sensitive Skin
Please Check any product(s) recommendation needed today?
Cleanser
Toner
Exfoliation
Serums
Moisturizer (AM/PM)
Sunscreen
Mask
Eye
Other:

HAVE YOU HAD ANY OF THE FOLLOWING:

Microdermabrasion?*
No
Yes
If so, when?
Chemical Peel?*
No
Yes
If so, when?
Laser Resurfacing?*
No
Yes
If so, when?
Collagen or Botox?*
No
Yes
If so, when?
Facial Surgery?*
No
Yes
If so, when?
Do you have permanent make up?*
No
Yes
If so, when?

LADIES ONLY:

Are you taking hormonal contraceptives?*
No
Yes
Are you pregnant or trying to become pregnant?*
No
Yes
Are you nursing?*
No
Yes
Experiencing any hormone/menopause problems?*
No
Yes

I hereby consent to and authorize Bare & Beautiful Esthetics LLC

to perform the following procedure:

Type of Facial: (write none if not receiving facial today)

Although it is impossible to list every potential risk and complication, I have been informed of possible benefits, risks, and complications. I also recognize there are no guaranteed results and that independent results are dependent upon age, skin condition, and lifestyle and that there is the possibility I may require further treatments of the treated areas to obtain the expected results at an additional cost. In the event that I may have additional questions or concerns regarding my treatment or suggested home product/ post-treatment care, I will consult with my esthetician immediately. I have also, to the best of my knowledge, given an accurate account of my medical history, including all known allergies or prescription drugs or products I am currently ingesting or using topically. I have read and fully understand this agreement and all information detailed above. I understand the procedure and accept the risks. All of my questions have been answered to my satisfaction and I consent to the terms of this agreement. I do not hold the esthetician responsible for any of my conditions that were present, and or was not disclosed at the time of this skin care procedure, which may be affected by the treatment performed today.

I understand facial packages are non-refundable under any circumstances! If you are not able to receive facials any longer you many use credit towards products or other services. 

Bare & Beautiful Esthetics offers product samples (try before you buy) therefore, I understand that all products purchased are non refundable this is also for safety purposes. 

I understand in the event if any major skin reaction that occurs certain support or after care may not be provided/suggested by the service provider (for safety reasons) instead you will need to contact your physician immediately. 







Parent or Guardian's Email Address
Email*
Confirm Email*
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*
Last Name*
Relationship*
Phone*
Parent or Guardian's Date of Birth*
Date of Birth
Parent or Guardian's Information
Who referred you today?

WAXING/SUGARING CONSENT FORM

Females clients: Are you currently Pregnant?*
No
Yes
Are you using AHA (Alpha Hydroxy Acid), Glycolic, Retin-a, Renova or Accutane (an oral form of Retin-a)?*
No
Yes
Are you using any blood/skin thinning products and/or drugs?*
No
Yes

MEDICAL DATA: 

Herpes Virus:*
No
Yes
Staph / MRSA:*
No
Yes
Have you ever had any adverse reactions to waxing/Sugaring?*
No
Yes

FACIAL /VAJACIAL CONSENT FORM 2025





Do you have any special skin problems or concerns?
Do you use Retin-A, Renova, or Retinol/vitamin A derivative products?*
No
Yes
Have you used any alpha-hydroxy acid or glycolic acid products in the last 48 hours?*
No
Yes
Are you currently taking Accutane or have you taken it in the past?*
No
Yes
How long ago?
Have you ever used Hydroquinone (skin lightener)?*
No
Yes
How long ago?
Have you used other acne medication?*
No
Yes
If yes, which one?
Any known allergies to skincare products or ingredients?*
No
Yes

WHAT SKIN CARE PRODUCTS ARE YOU CURRENTLY USING? PLEASE LIST THE BRAND IF KNOWN:

Cleanser & Toner (if any)
Exfoliation/Scrubs:
Treatment /Acne Product:
Moisturizer Day & Night
SPF:
PLEASE CHECK ANY AREAS OF CONCERN YOU HAVE REGARDING YOUR SKIN:
Acne
Blackheads
Whiteheads
Excessive Oil
Rosacea
Broken Capillaries
Redness
Uneven Skin Tone
Wrinkles
Sun Damage
Dull/Dry Skin
Flakey Skin
Dehydrated Skin
Sensitive Skin
Please Check any product(s) recommendation needed today?
Cleanser
Toner
Exfoliation
Serums
Moisturizer (AM/PM)
Sunscreen
Mask
Eye
Other:

HAVE YOU HAD ANY OF THE FOLLOWING:

Microdermabrasion?*
No
Yes
If so, when?
Chemical Peel?*
No
Yes
If so, when?
Laser Resurfacing?*
No
Yes
If so, when?
Collagen or Botox?*
No
Yes
If so, when?
Facial Surgery?*
No
Yes
If so, when?
Do you have permanent make up?*
No
Yes
If so, when?

LADIES ONLY:

Are you taking hormonal contraceptives?*
No
Yes
Are you pregnant or trying to become pregnant?*
No
Yes
Are you nursing?*
No
Yes
Experiencing any hormone/menopause problems?*
No
Yes

I hereby consent to and authorize Bare & Beautiful Esthetics LLC

to perform the following procedure:

Type of Facial: (write none if not receiving facial today)

Although it is impossible to list every potential risk and complication, I have been informed of possible benefits, risks, and complications. I also recognize there are no guaranteed results and that independent results are dependent upon age, skin condition, and lifestyle and that there is the possibility I may require further treatments of the treated areas to obtain the expected results at an additional cost. In the event that I may have additional questions or concerns regarding my treatment or suggested home product/ post-treatment care, I will consult with my esthetician immediately. I have also, to the best of my knowledge, given an accurate account of my medical history, including all known allergies or prescription drugs or products I am currently ingesting or using topically. I have read and fully understand this agreement and all information detailed above. I understand the procedure and accept the risks. All of my questions have been answered to my satisfaction and I consent to the terms of this agreement. I do not hold the esthetician responsible for any of my conditions that were present, and or was not disclosed at the time of this skin care procedure, which may be affected by the treatment performed today.

I understand facial packages are non-refundable under any circumstances! If you are not able to receive facials any longer you many use credit towards products or other services. 

Bare & Beautiful Esthetics offers product samples (try before you buy) therefore, I understand that all products purchased are non refundable this is also for safety purposes. 

I understand in the event if any major skin reaction that occurs certain support or after care may not be provided/suggested by the service provider (for safety reasons) instead you will need to contact your physician immediately. 







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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