Name *

First Name

Last Name

Please Read Carefully and check the following as an acknowledgment and agreement to the following statements. *

Checking the boxes on this online form takes the place of a client initial

I understand that Facial Boutique services, including facials and body treatments given at Facial Boutique, are for the sole purpose of skin cleansing, body and mind relaxation and rejuvenation.

I understand that it is imperative to tell my Esthetician about any oral or topical medications prior to any facial, waxing, spray tanning, or body treatment services.

I understand that Facial Boutique and its staff do not diagnose illness, disease, or any other physical or mental disorder. I accept full responsibility of the use of Facial Boutique at my own risk, and do not hold Facial Boutique or its staff liable for loss, damage or injury.

I understand that results are personable and not guaranteed.

I confirm that to the best of my knowledge that the answers given on Client Information Form are correct and that I have not withheld any information that may be relevant to my treatment at Facial Boutique.

I understand that I must provide at least 24 hours advance notice for the cancellation of an appointment.

I understand that Facial Boutique has a strict 24-Hour Cancellation Policy. In the event of a late cancellation / no show, the fee is $50.00. An invoice will be sent via square. If we are to replace appointment with a client on wait list, we are happy to waive the fee.

I understand there are side effects associated with skincare treatments. These side effects included but are not limited to: mild to moderate redness, mild to moderate peeling or flaking, stinging, dry skin, ternderness, pimples, cold sores or allergic reactions. Most side effects are temporary and will dissipate within 3-7 days.

Date *

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