Loading...

Self&Care is a place where everybody is welcome, no matter what size, shape, or ability. By providing custom skin care, brow & lash services, & body hair removal, you'll leave feeling a fresher, refined version of the beautiful person you already walked in as.

selfandcare.com

Please be advised in order to protect the integrity of your skin we cannot perform any waxing or sugaring services on clients who are using the following prescribed medications: Retin-A, Accutane, antibiotics, blood thinners, or heart medication. Use of these medications may also limit our ability to perform any facial services. 

I understand and agree to the following:

  • The skin, lash/brow perm/lamination, or hair removal treatment has been explained to me in detail by my Self&Care Esthetician and that for optimum results, a home treatment product program is needed to achive optimum results.
     
  • I may need several administrations of this treatment, IN ADDITION to following the home care advice of my esthetician to achieve my best results.
     
  • This treatment does not need to be administered by a physician and addition to receiving formal training, the Esthetician or Cosmetologist who administers treatment(s) also has a license with the state of California.
     
  • Self&Care facial, hair removal, facial, or lash perming treatment I receive is provided for the basic purpose of cosmetic skin care.
     
  • There are a small number of individuals who may have an allergic reaction to wax, sugar, skin care products, lash/brow perms/lamination, tints, hair dyes, and other chemical treatments. It is only in rare situations that the reaction can be severe.
     
  • If I experience any adverse side effects that appear to be attributable to a service recieved or my use of home care products, I will discontinue use of the products and notify Self&Care.
  • Some redness/irritation is possible. If I experience any pain or discomfort during a service, I will immediately notify my Self&Care Esthetician or Cosmeologist.

  • Those who have experienced an allergic reaction to henna or to hair dye containing para-phenylenediamine (PPD), may also develop an allergic rash to lash or brow dyes, and should not use them.

  • I have the right to request a patch test to check for sensitivity, which should be performed at least an hour prior to my appointment. In the event I feel this is necessary, I must let Self&Care know 24 hours before my appointment in order for time to be set aside for this. 

  • Although my Self&Care Esthetician will perform services on my lashes or brows using proper technique, the instruments, tapes, cleaners, eye gel pads, perm solutions, and color tints may irritate my eyes and in rare cases eye infection or blurriness may occur.

  • If I experience any of these conditions DURING or AFTER the ANY service, I will inform my Self&Care Esthetician or Cosmetologist and consult a physician at my own expense, and will not hold my Esthetician liable for any costs that may occur in the event of medical care.

  • I have read and understand ALL the above. 

I Agree

I understand that I will advise Self&Care if I am on ANY of the following treatments and that I may not receive clinical procedure(s) if I am currently using or experiencing any the following:

  • Accutane or Isotretinoin, antibiotics, blood thinners, or heart medication within 1 year.
  • Retinoids or vitamin A derivatives, including retinoic rcid (Retin-A, Renova, etc), within 1 week.
  • Recently received a facial or are undergoing reparative skin treatments including but not limited to, chemical peels, laser hair removal, microdermabrasion, and dermaplaning. 
  • Received injectables (fillers, Botox), within 2 weeks.
  • Recent chemotherapy or radiation.
  • Recieved hair removal (waxing, sugaring, threading, laser, electrolysis, creams), within 1 week.
  • Use of alpha or beta hydroxy acids, within 1 week.
  • Other manual exfoliating treatments, including Clarisonic or other facial cleansing brushes, within 1 week.
  • If I am pregnant or breastfeeding.
  • Recieved lash extensions, lash lift, or microblading within 1 month. 
  • Use of tanning beds (or any heat treatments) and/or sunburns 48 hours before waxing.

I Agree

Assumption of the Risk and Waiver of Liability Relating to Coronavirus/COVID-19 and Other Infectious Diseases

The novel coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health Organization. COVID-19 is extremely contagious and is believed to spread mainly from person-to-person contact. As a result, federal, state, and local governments and federal and state health agencies recommend social distancing and have, in many locations, prohibited the congregation of groups of people.

By signing this waiver the client is fully aware of the current pandemic and the inherent risks involved.  The client is aware that the majority of serious cases and deaths contributing to this virus are in people over 60 years old.

Self&Care Skin Studio (referred to here as “the Business” and/or “esthetics service provider”) has put in place preventative measures to reduce the spread of COVID-19; however, we cannot guarantee that you will not become infected with COVID-19 or any other infectious diseases/viruses.  Further, like any public place, could increase your risk of contracting COVID-19.

By signing this agreement: 

  • I understand and agree that if I have tested positive or have been exposed to someone with COVID-19 or any other infectious diseases/viruses, I will NOT visit this business, and reschedule my appointment at least 14-days after the last day of symptoms and/or last day of exposure. 
  • I understand and agree that if I have tested positive or have been exposed to someone with COVID-19 or any other infectious diseases/viruses in the last 30 days, it is at the discretion of my esthetician if the appointment is safe to perform, and that my appointment may be rescheduled to a later date. 
  • I acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that I may be exposed to or infected by COVID-19 or any other infectious diseases/viruses by visiting or coming on to the Business’ property and that such exposure or infection may result in personal injury, illness, permanent disability, and/or death.
  • I understand that the risk of becoming exposed to or infected by COVID-19 or any other infectious diseases/viruses at the Business may result from the actions, omissions, or negligence of myself and others, including, but not limited to, the Business’ employees, volunteers, and clients and their families.
  • I voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any injury to myself for (including, but not limited to, personal injury, disability, and death), illness, damage, loss, claim, liability, or expense, of any kind, that I may experience or incur in connection with my attendance or presence at the Business or participation in the Business’ programming, events, or appointments (“Claims”). 
  • I hereby release, covenant not to sue, discharge, and hold harmless the Business, its employees, agents, and representatives, of and from the Claims, including all liabilities, claims, actions, damages, costs or expenses of any kind arising out of or relating thereto. 
  • I understand and agree that this release includes any Claims based on the actions, omissions, or negligence of the Business, its employees, agents, and representatives, whether a COVID-19 or any other infectious diseases/viruses infection occurs before, during, or after participation in any Business program, event, or appointment.
  • I will comply to the business' new regulations including but not limited to wearing a face covering at all times, waiting in my car until notified to enter the building, santizing my hands before entering the studio, and arriving to my appointment alone. 

I Agree

I understand and agree to the following booking and cancellation policy:

I understand a card is required to be kept on file for ALL bookings, which is not charged, only held for Self&Care's cancellation policy. I understand all appointments cancelled within 12 hours of the appointment time will be considered a no-show and charged 50% of the full service cost. Groupons or any other prepaid vouchers are for first time clients only and can only be used once. 

I Agree
 

I understand and agree to the following:

I legally release my Self&Care Esthetician or Cosmeologist from all liability associated with any and all services offered and performed (waxing, sugaring, threading, tweezing, tinting, facials, lash perming, brow lamination/perming), which is performed with the utmost attention to safety and proper application using tools and products that the Esthetician or Cosmetologist is licensed, insured, and professionally trained to use. 

I Agree

Please select who will be receiving services...
AdultMinor
Continue
First Client Name

First Name*

Last Name*

Phone*
First Client Date of Birth*
First Client Signature*
Parent or Guardian's Email Address

Email*

Confirm Email*
Check to receive information, news, and discounts by e-mail.
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*

Phone*
Parent or Guardian's Date of Birth*
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.


One or more problems exist. Please scroll up.




Powered by  Smartwaiver - TRY IT FREE!