Spa & Permanent Makeup Consultation + Liability Waiver (Facials • Skin Treatments • Microshading Brows • Lip Blushing) "*" indicates required fields FacebookThis field is for validation purposes and should be left unchanged.Client InformationFull Name*Phone Number*Email* Date of Birth* MM slash DD slash YYYY Appointment Date* MM slash DD slash YYYY Service ConsultationDesired Service(s)*Facial ServiceBody TreatmentScalp TreatmentSkin TreatmentMicroshading BrowsLip BlushingOtherOtherSPA CONSULTATIONSkin Type*NormalDryOilyCombinationSensitiveCurrent Skin Concerns*AcneDryness/DehydrationHyperpigmentationFine Lines/WrinklesRedness/IrritationUneven TextureOtherOtherCurrent Skincare RoutineProducts UsedAre you currently using: Retinol/Retinoids Prescription Skincare Exfoliating Acids (AHA/BHA) Acne Treatments None Skin & Health HistoryDo you have allergies or sensitivities to skincare products, cosmetics, fragrances, essential oils, latex, or adhesives? No Yes Please explainHave you experienced reactions to Facials Chemical Peels Waxing Makeup Skincare Products None Do you currently have Eczema Psoriasis Rosacea Cold Sores Skin Infection Open Cuts/Wounds None Are you currently Pregnant/Nursing Taking Prescription Medications Taking Blood Thinners Using Accutane or Similar Medication None Medications/SupplementsPermanent Makeup Consultation (Microshading Brows & Lip Blushing)Desired Service Microshading Brows Lip Blushing Both Services Desired Results:Brows Natural Soft Ombré Defined/Full Other OtherLips Natural Tint More Defined Shape Brighter Color Neutral/Nude Tone Other OtherPermanent Makeup HistoryHave you previously received permanent makeup? No Yes Service & Date:Have you had any of the following near the service area? Botox Fillers Chemical Peel Laser Treatment Facial Treatment Date MM slash DD slash YYYY Client Acknowledgment & Consent I understand that spa and permanent makeup services are customized based on my skin type, health history, and individual needs.I understand: Results may vary depending on skin type, lifestyle, healing process, and aftercare. Some services may cause temporary redness, sensitivity, swelling, dryness, or irritation. Permanent makeup requires proper aftercare and may require additional touch-up sessions. Pigment may fade, soften, or change over time. Multiple sessions may be needed to achieve desired results. Final results cannot be guaranteed due to individual skin response. I confirm that I have disclosed all allergies, medical conditions, medications, and relevant information that may affect my service.Liability Release I voluntarily consent to receive spa and/or permanent makeup services from K&M Dew Glam Lounge. I release and hold harmless K&M Dew Glam Lounge, its artists, estheticians, employees, and representatives from liability for allergic reactions, sensitivities, skin responses, pigment retention issues, healing complications, irritation, or results affected by undisclosed information, improper aftercare, or individual response. I understand that spa treatments and permanent makeup services are cosmetic enhancements and not medical procedures. Photo & Marketing ConsentMay K&M Dew Glam Lounge use photos/videos of your service results for portfolio, website, and social media? Yes, I give permission No, I do not give permission Client SignatureClient SignatureArtist/Esthetician SignatureDate MM slash DD slash YYYY Date MM slash DD slash YYYY
